| NPI | 1093081994 |
|---|---|
| Former Name | TRACY ANNE MANDELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2023-02-07 |