Individual
BRANDIE TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1114 SW A AVE, LAWTON, OK 73501-3819
(580) 357-8114
Mailing address
1114 SW A AVE, LAWTON, OK 73501-3819
(580) 357-8114
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
175T00000X
Peer Specialist
—
OK
Other
Enumeration date
04/28/2021
Last updated
04/28/2025
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