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Individual

JENNIFER TUCKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
400 STODDARD RD, RICHMOND, MI 48062-2505
(810) 987-1258
Mailing address
1320 7TH ST APT 2, PORT HURON, MI 48060-5902
(810) 588-1757

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MI

Other

Enumeration date
07/28/2015
Last updated
07/28/2015
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