Individual
LAKENDRA CHARISSE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1706 BENTLEY CT, COLUMBIA, SC 29210-3600
(803) 543-6445
Mailing address
1706 BENTLEY CT, COLUMBIA, SC 29210-3600
(803) 543-6445
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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