Individual
MRS. TRICIA HOPE FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1200 E JAMES LEE BLVD, CRESTVIEW, FL 32539-3126
(506) 894-6878
Mailing address
1192 JENNINGS TRCE, HOLT, FL 32564-9660
(850) 375-4375
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH17703
FL
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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