Individual
LARRY G TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
310 E 38TH ST, SUITE 320, MINNEAPOLIS, MN 55409
(612) 343-1600
Mailing address
310 E 38TH ST, SUITE 320, MINNEAPOLIS, MN 55409
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1198
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62-70808
UBH IDENTIFICATION NUMBER
MN
01
—
978T9KE
BCBS
MN
Enumeration date
01/11/2007
Last updated
11/21/2007
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