Individual
KIMBERLY TUCKER SIWIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
140 WADSWORTH RD, WADSWORTH, OH 44281-9503
(330) 667-0260
Mailing address
479 SHOREFIELD DR, CHIPPEWA LAKE, OH 44215-9721
(330) 612-0874
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C2002234TRNE
OH
101YM0800X
Mental Health Counselor
Primary
E.2303516
OH
Other
Enumeration date
01/28/2020
Last updated
06/16/2023
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