BOONE MARTIN TUCKER

SAN LUIS OBISPO, CA
NPI1902521966
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  RT1437960426)
Enumeration Date2022-10-11
Last Update Date2026-04-10
Business Address
BOONE MARTIN TUCKER
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401-4558
Phone number: 805-473-7081
Mailing Address
BOONE MARTIN TUCKER
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401-4558
Phone number: 805-473-7081