Individual
MR. PAUL TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849
(580) 925-3286
(580) 925-2362
Mailing address
527 W 3RD ST, PO BOX 358, KONAWA, OK 74849
(580) 925-3286
(580) 925-2362
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2063
OK
Other
Enumeration date
10/19/2006
Last updated
04/02/2015
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