Individual
JILL DANIELLE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828
(434) 200-5750
(434) 237-1737
Mailing address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828
(434) 200-5750
(434) 237-1737
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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