Tracy Dian Fountain, BHRS

NPI #1194095273 in Welling, Oklahoma

Provider Information

NPI Number: 1194095273
Entity Type: Individual
Name: Tracy Dian Fountain, BHRS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: BHRS
Enumeration Date: Jan 6, 2012
Last Updated: Jan 6, 2012

Practice Location

Address: 27753 S WELLING RD
City: Welling
State: Oklahoma
ZIP Code: 74471-2202
Phone: (918) 457-4999

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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