| NPI | 1003968116 | 
|---|---|
| Former Name | TRACIE L. MERTZ | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: SC 686) | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: SC 686) | 
| 103TA0700X Psychologist, Adult Development & Aging (Licence: SC 686) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: SC 686) | |
| 103TC0700X Psychologist, Clinical (Licence: SC 686) | |
| 103TH0100X Psychologist, Health Service (Licence: SC 686) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: SC 686) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: SC 686) | |
| Enumeration Date | 2007-01-17 | 
| Last Update Date | 2021-07-08 |