Most Relevant Information
Provider Data
| NPI Number: | 1003695875 |
| Provider Name: | DOMINIQUE TUCKER |
| Entity Type: | Individual |
| Taxonomy Code: | 106E00000X |
| Specialty: | Assistant Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/21/2023 |
| Last Updated: | 09/21/2023 |
Provider Practice Location
7108 S KANNER HWY
STUART
FL
349977462
Practice Location Phone/Fax
| Phone: | 8558326727 |
| Fax: |
Provider Mailing Location
7108 S KANNER HWY
STUART
FL
349977462
Provider Mailing Phone/Fax
| Phone: | 8558326727 |
| Fax: |