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Individual

TRACIE OWEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
333 W MAIN ST STE 210, ARDMORE, OK 73401-6320
(580) 224-2929
Mailing address
1219 S ROCKFORD RD, ARDMORE, OK 73401-3650

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
OK

Other

Enumeration date
12/21/2017
Last updated
12/22/2017
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