Mallory Tucker

NPI #1194369850 in Waterford, Michigan

Provider Information

NPI Number: 1194369850
Entity Type: Individual
Name: Mallory Tucker
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Nov 5, 2019
Last Updated: Nov 5, 2019

Practice Location

Address: 7328 ARBOR TRL APT 201
City: Waterford
State: Michigan
ZIP Code: 48327-4501
Phone: (616) 818-9104

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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