Individual
MRS. JENNIFER JEAN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3051 WATSON BLVD, WARNER ROBINS, GA 31093-8536
(478) 953-7556
Mailing address
3051 WATSON BLVD, WARNER ROBINS, GA 31093-8536
(478) 953-7556
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
OTA001193
GA
Other
Enumeration date
12/18/2009
Last updated
12/18/2009
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