JASON LAMAR TUCKER

ST AUGUSTINE, FL
NPI1194212027
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2018-04-17
Last Update Date2018-04-17
Business Address
Mr. JASON LAMAR TUCKER
3574 US 1 S STE 101104
ST AUGUSTINE, FL 32086-6466
Phone number: 904-217-7161
Mailing Address
Mr. JASON LAMAR TUCKER
3574 US 1 S STE 101104
ST AUGUSTINE, FL 32086-6466
Phone number: 904-217-7161