Individual
MAKENNA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
105 LAURA LN, CERESCO, NE 68017-4130
(712) 266-5558
Mailing address
105 LAURA LN, CERESCO, NE 68017-4130
(712) 266-5558
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2363
NE
Other
Enumeration date
09/13/2019
Last updated
05/21/2024
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