| NPI | 1235291675 |
|---|---|
| Former Name | TELIA YEVETTE TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C005273) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC C005273) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2010-01-19 |