Individual
JENNIFER ANN TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7913 NW 28TH TER, BETHANY, OK 73008-4465
(512) 373-6903
Mailing address
823 N VILLA AVE, OKLAHOMA CITY, OK 73107-6439
(512) 373-6903
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/20/2020
Last updated
04/20/2020
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