Individual
DR. JAMES L TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
124 E MIRACLE STRIP PKWY, SUITE 302, MARY ESTHER, FL 32569-1988
(850) 243-8086
(850) 243-2702
Mailing address
124 E MIRACLE STRIP PKWY, SUITE 302, MARY ESTHER, FL 32569-1988
(850) 243-8086
(850) 243-2702
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
732
CO
103TC0700X
Clinical Psychologist
Primary
PY9444
FL
103TC2200X
Clinical Child & Adolescent Psychologist
732
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K3215
MEDICARE GROUP
FL
Enumeration date
01/16/2007
Last updated
01/29/2016
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