Individual
MS. ROLANDA OLA TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 MANCHESTER AVE, YOUNGSTOWN, OH 44509-4450
(330) 774-4794
Mailing address
119 MANCHESTER AVE, YOUNGSTOWN, OH 44509-2306
(330) 774-4794
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
0077801
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077801
—
OH
Enumeration date
06/24/2014
Last updated
04/24/2020
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