| Doctor Name: | MRS. CECILIA ANN TUCKER |
| NPI Number: | 1720219215 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CACIII - COLORADO AD |
| License Number: | 1445 |
| Business Practice Address: | 296 Mouache Road Ignacio, CO - 81137 |
| Business Phone Number: | 9705634555 |
| Business Fax Number: | 9705634618 |
| Mailing Address: | P.o. Box 429, IGNACIO |
| State: | CO |
| Postal Code: | 81137 |
| Phone Number: | 9705634555 |
| Fax Number: | 9705634616 |
| NPI Enumeration Date: | 07/31/2009 |
| NPI Last Update Date: | 07/31/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 1445 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |