Individual
KAITLYN PAMELA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 S BYRNE RD, TOLEDO, OH 43615-6212
(419) 531-5544
Mailing address
111 S BYRNE RD, TOLEDO, OH 43615-6212
(419) 531-5544
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
S.2309437
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S.2309437
COUNSELOR, SOCIAL WORKER & MFT BOARD
OH
Enumeration date
07/17/2023
Last updated
07/17/2023
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