| Doctor Name: | MRS. MARISA TUCKER |
| NPI Number: | 1053346874 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W. |
| License Number: | 44SC05278800 |
| Business Practice Address: | 24 Beverly Rd West Orange, NJ - 070524608 |
| Business Phone Number: | 9738096446 |
| Business Fax Number: | |
| Mailing Address: | 35 Shadowlawn Dr, LIVINGSTON |
| State: | NJ |
| Postal Code: | 070393144 |
| Phone Number: | 9739941752 |
| Fax Number: | |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 09/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 44SC05278800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |