Doctor Name: | SAVANNAH RAE TUCKER |
NPI Number: | 1043504434 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 65331 |
Business Practice Address: | 1243 Cherrywood Kyle, TX - 786405747 |
Business Phone Number: | 5127096475 |
Business Fax Number: | |
Mailing Address: | 1243 Cherrywood, KYLE |
State: | TX |
Postal Code: | 786405747 |
Phone Number: | 5127096475 |
Fax Number: | |
NPI Enumeration Date: | 06/03/2011 |
NPI Last Update Date: | 06/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 65331 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |