Individual provider · Type 1 NPI

Michael Juckett

Addiction (Substance Use Disorder) Counselor · South Lake Tahoe, CA

NPI number 1629272869 Active

Practice location

1137 Emerald Bay Rd
South Lake Tahoe, CA 96150-6207

Call (530) 541-5190 Map

Mailing address

PO Box 16435
South Lake Tahoe, CA 96151-6435

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1629272869

Michael Juckett's National Provider Identifier is 1629272869, issued on Jun 12, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in South Lake Tahoe, CA. The record was last updated on Jul 8, 2007.