| NPI | 1063307197 |
|---|---|
| Former Name | TRACY LOCKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CG70010924) |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-10 |