Individual
MRS. LACEY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4255 MEDWELL DR, NEWBURGH, IN 47630
(812) 853-2293
Mailing address
403 N 2ND ST, BOONVILLE, IN 47601-1201
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005387A
IN
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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