Provider Demographics
NPI:1952013039
Name:SUCHER, KELLY EUGENIA
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:EUGENIA
Last Name:SUCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 MEMORIAL CIR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-5004
Mailing Address - Country:US
Mailing Address - Phone:405-529-5339
Mailing Address - Fax:
Practice Address - Street 1:4505 MEMORIAL CIR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-5004
Practice Address - Country:US
Practice Address - Phone:405-529-5339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker