Individual
CANDACE DEANNE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1800 E MEMORIAL RD STE 105, OKLAHOMA CITY, OK 73131-1827
(405) 226-5273
Mailing address
6506 STONE VALLEY DR, EDMOND, OK 73034-9558
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3547
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200359070A
—
OK
Enumeration date
02/01/2010
Last updated
08/08/2022
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