Individual
KEISHA LASHAY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
260 MARCELLA RD APT 504, HAMPTON, VA 23666-2594
(757) 979-4121
Mailing address
260 MARCELLA RD APT 504, HAMPTON, VA 23666-2594
(757) 979-4121
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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