| NPI | 1396097457 |
|---|---|
| Former Name | FARTIMA TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801094903) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2025-03-08 |