Individual
JOBRENA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2530 S COMMERCE ST BLDG C, ARDMORE, OK 73401-5519
(580) 226-5048
Mailing address
1076 BREEZEWOOD RD, ARDMORE, OK 73401-9444
(580) 222-4961
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/12/2011
Last updated
06/08/2016
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