Individual
PHILLIP MICHAEL TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC - MHSP
Contact information
Practice address
3889 WONDERLAND LN, SEVIERVILLE, TN 37862-8288
(865) 366-7218
Mailing address
1514 MAURY ST, ALCOA, TN 37701-2028
(865) 640-1782
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4446
TN
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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