Basic Information
| Provider Information | |||||||||
| NPI: | 1326657552 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TUCKER | ||||||||
| FirstName: | EMILEE | ||||||||
| MiddleName: | VICTORIA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2260 WINTERFIELD DR | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280569224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046850440 | ||||||||
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| Practice Location | |||||||||
| Address1: | 304 10TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286013883 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283222183 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/23/2020 | ||||||||
| LastUpdateDate: | 07/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 14338 | NC | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.