Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1982940540 |
---|---|
Provider Name | Mrs. S Yvette Tucker |
First Address | Atlanta, GA 30325-0514 |
Second Address | Atlanta, GA 30309-1090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2012 |
Last Update Date | 28/12/2012 |