MR. Cory Ray Thackeray

NPI #1013765940 in Tulsa, Oklahoma

Provider Information

NPI Number: 1013765940
Entity Type: Individual
Name: MR. Cory Ray Thackeray
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: May 7, 2024
Last Updated: May 7, 2024

Practice Location

Address: 1728 S CARSON AVE
City: Tulsa
State: Oklahoma
ZIP Code: 74119-4610
Phone: (918) 946-1209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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