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1982973244
KEISH MALYN TUCKER
BLACKWOOD, NJ
NPI
1982973244
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Former Name
KEISH MALYN PARKER
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NJ 44SC05314300)
Enumeration Date
2011-12-15
Last Update Date
2020-05-08
Business Address
KEISH MALYN TUCKER LCSW
875 ERIAL RD
BLACKWOOD, NJ 08012-3931
Phone number: 856-227-1400
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Mailing Address
KEISH MALYN TUCKER LCSW
875 ERIAL RD
BLACKWOOD, NJ 08012-3931
Phone number: 856-227-1400
Copy
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