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General NPI Number Information
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NPI Number | 1174402424
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Entity Type | Individual
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Provider Name | KEILA TUCKLER LSP
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Gender | Female
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Dates
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Enumeration Date | 08/30/2025
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 3699 AIRFIELD DR W STE 1
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City | LAKELAND
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State | FL
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Zip | 33811-1266
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Country | US
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Telephone | 786-558-9123
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Fax |
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Provider Business Mailing Address
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Address Line | 17000 NW 67TH AVE APT 232
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City | HIALEAH
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State | FL
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Zip | 33015-4059
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Country | US
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Telephone | 305-733-0711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS1892
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License Number State | FL
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