Individual
CARLY TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
10 FOUNTAINVIEW TER, GREENVILLE, SC 29607-4060
(864) 528-5501
Mailing address
356 SILVER CT, YORK, SC 29745-9404
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5087
SC
225X00000X
Occupational Therapist
9967
NC
Other
Enumeration date
04/18/2017
Last updated
02/20/2020
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