person
Mr. Charles Lee Tucker I, LADC
Addiction (Substance Use Disorder) Counselor in Spencer, Oklahoma
NPI 1497039135

Charles Lee Tucker I is an Addiction (Substance Use Disorder) Counselor based in Spencer, OK and is specialized in Addiction (Substance Use Disorder). Charles Lee Tucker I practices in Spencer, OK and has the professional credentials of LADC. The NPI Number for Charles Lee Tucker I is 1497039135 and holds a License No. 1225 (Oklahoma).

The current practice location address for Charles Lee Tucker I is 12925 Ne 59Th St, Spencer, OK and can be reached out via phone at 405-464-2922.

Location: 12925 Ne 59Th St, Spencer, OK, 73084-8605
person
Provider Profile Details
NPI Number
1497039135
Provider Name
Charles Lee Tucker I
Credential
LADC
Provider Entity Type
Individual
Gender
Male
Address
12925 Ne 59Th St, Spencer, OK, 73084-8605
Phone Number
405-464-2922
Fax Number
Provider Enumeration Date
09/29/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1225 01 NPI
1225 01 OK NPI
institution
Provider Business Practice Location Address Details
Address
12925 Ne 59Th St
City
State
Zip
73084-8605
Phone Number
405-464-2922
Fax Number
person
Provider Business Mailing Address Details
Address
12925 Ne 59Th St
City
State
Zip
73084-8605
Phone Number
405-464-2922
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
1225 (Oklahoma)
Definition
Definition to come...
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