Provider Demographics
NPI:1548669690
Name:TUCKER, MARIA P
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:P
Last Name:TUCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 OGDEN AVE # 22
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-4347
Mailing Address - Country:US
Mailing Address - Phone:347-431-4384
Mailing Address - Fax:
Practice Address - Street 1:1131 OGDEN AVE # 22
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-4347
Practice Address - Country:US
Practice Address - Phone:347-431-4384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool