Individual
MRS. HOLLY LYNN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
102 WHITE TAIL CT, GREENVILLE, SC 29607-4947
(864) 436-9568
Mailing address
102 WHITE TAIL CT, GREENVILLE, SC 29607-4947
(864) 436-9568
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301100
—
SC
Enumeration date
03/06/2013
Last updated
12/16/2015
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