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Individual

MRS. JODY ANN ST. GEORGE TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MT-BC, MA

Contact information

Practice address
2645 MIDWAY RD, DULUTH, MN 55810-2112
(218) 349-1792
Mailing address
2645 MIDWAY RD, DULUTH, MN 55810
(218) 349-1792

Taxonomy

Speciality
Code
Description
License number
State
225A00000X
Music Therapist
07105
MN
225A00000X
Music Therapist
Primary
07105

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07105
MUSIC THERAPIST
MN
Enumeration date
05/22/2007
Last updated
06/17/2015
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