Individual
ALICIA TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
421 23RD AVE E, TUSCALOOSA, AL 35404-3039
(334) 328-0815
Mailing address
3763 DELRAY LN, NORTHPORT, AL 35473-2441
(334) 328-0815
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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