Healthcare Provider Details

I. General information

NPI: 1427332915
Provider Name (Legal Business Name): MS. GLORIA DEAN TUCKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 NE 28TH ST STE 101
OKLAHOMA CITY OK
73105-2822
US

IV. Provider business mailing address

2516 NW 115TH ST
OKLAHOMA CITY OK
73120-6609
US

V. Phone/Fax

Practice location:
  • Phone: 405-990-0725
  • Fax: 877-497-3862
Mailing address:
  • Phone: 405-752-4259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: