MISS Ticola Shondroda Tucker

NPI #1023720489 in Columbia, South Carolina

Provider Information

NPI Number: 1023720489
Entity Type: Individual
Name: MISS Ticola Shondroda Tucker
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Dec 16, 2022
Last Updated: Dec 16, 2022

Practice Location

Address: 1301 MAIN ST STE 300
City: Columbia
State: South Carolina
ZIP Code: 29201-3203
Phone: (877) 418-2978

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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