MEDICARE: MRS. TRENEE L TUNICK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6516	OK

General Provider Information

NPI Number	:	1841683125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TRENEE L TUNICK LCSW

Provider Business Mailing Address
First Line	:	5708 NW 135TH ST STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-5942
Country	:	US
Telephone Number	:	405-696-7442
Fax Number	:	855-940-4072

Provider Business Practice Location Address
First Line	:	5708 NW 135TH ST STE B
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73142-5942
Country	:	US
Telephone Number	:	405-697-6737
Fax Number	:	855-940-4072

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2015
Last Update Date	:	07/12/2022

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