Individual
KHARISA REE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4221 OLIVIA DR, ADDIS, LA 70710-3044
(337) 329-2935
Mailing address
4221 OLIVIA DR, ADDIS, LA 70710-3044
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
13295
LA
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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