Individual
MS. LILLIE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
810 CLASSON AVE, BROOKLYN, NY 11238-6102
(718) 230-5100
(718) 230-5425
Mailing address
810 CLASSON AVE, BROOKLYN, NY 11238-6102
(718) 230-5100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19883
NY
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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