Individual
KAREN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
333 E WASHINGTON ST, SUITE 2000, WEST BEND, WI 53095-2585
(262) 335-4545
(262) 335-6827
Mailing address
333 E WASHINGTON ST, SUITE 2000, WEST BEND, WI 53095-2585
(262) 335-4545
(262) 335-6827
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1662-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39091600
—
WI
Enumeration date
08/21/2006
Last updated
07/08/2007
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