Individual
MS. REGINA JASMINE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMH,CNS,BC
Contact information
Practice address
1330 MCCORMICK DR, LARGO, MD 20774-5398
(301) 772-1200
(301) 772-8442
Mailing address
1330 MCCORMICK DR, LARGO, MD 20774-5398
(301) 772-1200
(301) 772-8442
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
R150127
MD
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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