Individual
LEILA MARIA TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
54 N MOUNTAIN BLVD, MOUNTAIN TOP, PA 18707-1117
(570) 362-1838
Mailing address
4 FAWN LN, NUANGOLA, PA 18707-9263
(570) 362-1838
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW012663L
PA
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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