Individual
MS. NIINA IRENE TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4411 W GORE BLVD, LAWTON, OK 73505-5977
(580) 695-5596
(580) 699-5950
Mailing address
4411 W GORE BLVD, LAWTON, OK 73505-5977
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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