Individual
MONIQUE CAMILLE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1777 AXTELL DR, TROY, MI 48084-4404
(248) 613-5377
Mailing address
30497 SALISBURY ST, FARMINGTON HILLS, MI 48336-5341
(313) 221-4313
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301017206
MI
Other
Enumeration date
09/08/2017
Last updated
09/08/2017
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