Individual
BREANA TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8080 E CENTRAL AVE STE 320, WICHITA, KS 67206-2389
(316) 927-3010
Mailing address
10541 SONDRA CT, MAIZE, KS 67101-4122
(316) 648-7259
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9584
KS
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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