Individual
MISTY FOUTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BHCM II
Contact information
Practice address
26243 HIGHWAY 51, WAGONER, OK 74467-8740
(918) 614-0778
(918) 999-0109
Mailing address
26243 HIGHWAY 51, WAGONER, OK 74467-8740
(918) 614-0778
(918) 999-0109
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/13/2015
Last updated
10/22/2018
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