| NPI | 1629682141 |
|---|---|
| Doing Business As | JESSICA STUCKER, LICSW, MLADC |
| Entity Type | Organization |
| Authorized Contact | JESSICA STUCKER Manager 857-302-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-11-11 |