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Individual

MS. GLORIA DEAN TUCKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2516 NW 115TH ST, OKLAHOMA CITY, OK 73120-6609
(405) 752-4259
Mailing address
2516 NW 115TH ST, OKLAHOMA CITY, OK 73120-6609
(405) 752-4259

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YP2500X
Professional Counselor
OK
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
10/04/2011
Last updated
10/04/2011
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