Mr. Cory Ray Thackeray
Mr. Cory Ray Thackeray is a Peer Specialist in Tulsa, Oklahoma. Practices as a sole proprietor. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
1728 S Carson AveTulsa, OK 74119-4610
Phone: (918) 946-1209
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Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X |
|---|
Record details
| NPI number | 1013765940 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | May 7, 2024 |
| Last updated in NPPES | May 7, 2024 |
| Certification date | May 7, 2024 |
| Mailing address | 1728 S Carson Ave, Tulsa, OK 74119-4610 |
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