Individual
TRACY NICOLE PHILLIP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9800 E 110TH ST N, OWASSO, OK 74055-6666
(918) 810-2428
Mailing address
9800 E 110TH ST N, OWASSO, OK 74055-6666
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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