| Doctor Name: | MRS. ANGELA TUCKER |
| NPI Number: | 1336264712 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SPEECH THERAPIST |
| License Number: | 4197 |
| Business Practice Address: | 463 Ashley Ridge Blvd Ste 100 Shreveport, LA - 711067231 |
| Business Phone Number: | 3186718772 |
| Business Fax Number: | 3186718776 |
| Mailing Address: | 463 Ashley Ridge Blvd Ste 100, SHREVEPORT |
| State: | LA |
| Postal Code: | 711067231 |
| Phone Number: | 3186718772 |
| Fax Number: | 3186718776 |
| NPI Enumeration Date: | 03/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 4197 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |