Individual
MS. LYDIA LINDA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACIII
Contact information
Practice address
2017 W EISENHOWER BLVD, LOVELAND, CO 80537-3139
(970) 461-0978
Mailing address
2017 W EISENHOWER BLVD, LOVELAND, CO 80537-3139
19704610978
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC0004213
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04727819
—
CO
Enumeration date
06/08/2017
Last updated
03/17/2018
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