Individual
TAMARA BRUCATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, LCSW, KPS
Contact information
Practice address
1030 SHIVE LN, BOWLING GREEN, KY 42103
(270) 943-1851
Mailing address
2702 INDUSTRIAL DR APT 610, BOWLING GREEN, KY 42101-4154
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
253490
KY
1041C0700X
Clinical Social Worker
5907
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30604011
—
KY
05
—
7100543720
—
KY
Enumeration date
01/03/2013
Last updated
08/27/2018
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