Doctor Name: | MRS. DENISE RENAE TUCKER |
NPI Number: | 1477820918 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 44SC05489700 |
Business Practice Address: | 1592b Union Valley Rd West Milford, NJ - 074801337 |
Business Phone Number: | 9736571222 |
Business Fax Number: | |
Mailing Address: | 69 Deer Trl S, GREENWOOD LAKE |
State: | NY |
Postal Code: | 109254216 |
Phone Number: | 8454770053 |
Fax Number: | |
NPI Enumeration Date: | 11/29/2011 |
NPI Last Update Date: | 01/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SC05489700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |