Individual
AMY LEE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
835 SAGINAW ST S, SALEM, OR 97302
(971) 301-4337
(971) 208-9874
Mailing address
4589 JULIANA LOOP SE, SALEM, OR 97317
(503) 881-4561
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C6918
OR
101YM0800X
Mental Health Counselor
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Other
Enumeration date
12/18/2017
Last updated
09/09/2022
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