Most Relevant Information
Provider Data
| NPI Number: | 1003278631 |
| Provider Name: | OLIVIA KATHLEEN TUCKER LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | 6801103784 |
Most Important Dates
| Enumeration Date: | 03/23/2016 |
| Last Updated: | 11/05/2024 |
Provider Practice Location
10801 S SAGINAW ST STE D
GRAND BLANC
MI
484398126
Practice Location Phone/Fax
| Phone: | 8107714074 |
| Fax: | 8108664450 |
Provider Mailing Location
1015 MARTHA CT
LAPEER
MI
484467605
Provider Mailing Phone/Fax
| Phone: | 8104416477 |
| Fax: | 8102327599 |