Individual
BRENNA TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN
Contact information
Practice address
3510 SCOTTS LN, PHILADELPHIA, PA 19129-1566
(612) 840-0349
Mailing address
3510 SCOTTS LN APT 3144, PHILADELPHIA, PA 19129-1691
(612) 840-0349
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN009119
PA
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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