| Audra Tucker, | |
|
1468 N Mustang Rd, Mustang, OK 73064-7214 | |
| (405) 376-1800 | |
| (405) 376-1856 |
| Full Name | Audra Tucker |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 1468 N Mustang Rd, Mustang, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275935090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 7005 (Oklahoma) | Primary |
| Entity Name | A Chance To Change Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326217795 PECOS PAC ID: 8022259985 Enrollment ID: O20130719000135 |
| Mailing Address | Practice Location Address |
|---|---|
| Audra Tucker, 5300 N Independence Ave Ste 280, Oklahoma City, OK 73112-5555 Ph: (405) 376-1800 | Audra Tucker, 1468 N Mustang Rd, Mustang, OK 73064-7214 Ph: (405) 376-1800 |
Misty Renee May, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1558 E. Lake Aire Lane, Mustang, OK 73064 Phone: 405-626-4128 | |
Pati Colston, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10912 S Czech Hall Rd, Mustang, OK 73064 Phone: 405-408-7862 | |
Mr. Steven Charles Carlson, M.S.W., L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 417 E Twelve Oaks Ter, Mustang, OK 73064 Phone: 405-206-8389 |