Individual provider · NPI-1

Evelyn Jean Tucker

Rehabilitation Counselor · Detroit, MI

NPI number1902663008
StatusActive
Last updated in NPPESMar 5, 2024

Details

NPI
1902663008
Entity type
Individual (NPI-1)
Name
Evelyn Jean Tucker
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 5, 2024
Certification date
Mar 5, 2024
Last updated
Mar 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225C00000X Rehabilitation Counselor6451015394MIYes

Practice location

5555 Conner St
Detroit, MI 48213-3448

Phone 313-729-0200

Mailing address

6341 Neff Ave
Detroit, MI 48224-1265

Phone 313-729-0020

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