| NPI | 1083089254 |
|---|---|
| Former Name | LENA TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MS M5558) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MS M5558) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |