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Individual

ELIZABETH ANNE DUNCKLEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
550 S PEORIA AVE, TULSA, OK 74120-3820
(918) 382-1229
(918) 582-6405
Mailing address
550 S PEORIA AVE, TULSA, OK 74120-3820
(918) 382-1229
(918) 582-6405

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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