Individual
ELIZABETH ANNE DUNCKLEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3194
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100732910-A
GROUP MEDICAID/SOONERCARE
OK
01
—
100732910-G
GROUP MEDICAID/SOONERCARE
OK
01
—
73-1042545
GROUP COMMUNITY CARE OF OKLAHOMA
OK
01
—
731042545001
GROUP TRICARE
OK
Enumeration date
10/03/2006
Last updated
06/19/2015
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