Individual provider · Type 1 NPI

Trista Deeann Gannon

Mental Health Counselor · Ardmore, OK

NPI number 1386991016 Active

Practice location

32 N Washington St
Ardmore, OK 73401-7013

Call (580) 226-5209 Map

Mailing address

PO Box 1546
Ardmore, OK 73402-1546

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1386991016

Trista Deeann Gannon's National Provider Identifier is 1386991016, issued on Aug 13, 2012. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Ardmore, OK. The record was last updated on Aug 13, 2012.