Individual
KEVIN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
5300 MEMORIAL DR STE 216, STONE MOUNTAIN, GA 30083-3134
(678) 481-6375
(678) 348-7215
Mailing address
5300 MEMORIAL DR STE 216, STONE MOUNTAIN, GA 30083-3134
(678) 481-6375
(678) 348-7215
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC007095
GA
Other
Enumeration date
01/07/2013
Last updated
04/03/2024
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