Individual
DEAUVIA RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14799 DIX TOLEDO RD, SOUTHGATE, MI 48195-2507
(734) 324-8326
Mailing address
20213 FAIRPORT ST, DETROIT, MI 48205-1126
(313) 433-2518
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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