Individual
KATHERINE E TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2118 3 MILE RD NW, GRAND RAPIDS, MI 49544-1425
(616) 222-3720
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801089634
MI
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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