Individual
JEAN C. TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED.,CCC-SLP
Contact information
Practice address
92 PORTSMOUTH AVE, STE 4, EXETER, NH 03833-2133
(603) 583-4514
(603) 583-4513
Mailing address
92 PORTSMOUTH AVE, STE 4, EXETER, NH 03833-2133
(603) 583-4514
(603) 583-4513
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0782
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0782
LICENSED ALLIED HEALTH PROFESSIONALS
NH
05
—
30401311
—
NH
Enumeration date
12/11/2008
Last updated
12/11/2008
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