Individual
MS. MARY BETH TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
141 DALTON ST, SHREVEPORT, LA 71106-7401
(318) 458-6754
Mailing address
141 DALTON ST, SHREVEPORT, LA 71106-7401
(318) 458-6754
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46
LA
Other
Enumeration date
06/29/2017
Last updated
07/21/2022
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