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General NPI Number Information
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NPI Number | 1780452656
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Entity Type | Individual
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Provider Name | TOSHIA ANN CUCCIAS
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Gender | Female
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 10320 N AIRPORT RD
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City | CLINTON
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State | OK
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Zip | 73601-7530
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Country | US
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Telephone | 580-331-2370
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Fax | 405-422-8282
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Provider Business Mailing Address
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Address Line | 1200 ORIENT AVE
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City | CLINTON
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State | OK
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Zip | 73601-2756
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Country | US
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Telephone | 580-500-8893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | OK
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