Individual
MR. RAH'SAAN RUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13913 WELLSBURG CT, EDMOND, OK 73013-7033
(405) 882-2119
Mailing address
13913 WELLSBURG CT, EDMOND, OK 73013-7033
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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