Individual
MR. JONATHAN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
6555 W MAPLE RD, WEST BLOOMFIELD, MI 48322-4926
(248) 592-2655
(248) 592-2660
Mailing address
6555 W MAPLE RD, WEST BLOOMFIELD, MI 48322-4926
(248) 592-2655
(248) 592-2660
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801086791
MI
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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