| NPI | 1568004182 |
|---|---|
| Former Name | TRACY L TUCKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00002768) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2022-03-23 |