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1205499811
TUCKER WALLACE
ST GEORGE, UT
NPI
1205499811
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2019-04-18
Last Update Date
2022-04-18
Business Address
TUCKER WALLACE
249 E TABERNACLE ST STE 100
ST GEORGE, UT 84770-2951
Phone number: 435-705-7574
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Mailing Address
TUCKER WALLACE
249 E TABERNACLE ST STE 100
ST GEORGE, UT 84770-2951
Phone number: 435-705-7574
Copy
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