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1114436326
TRACY M HUMPHRESS
EAU CLAIRE, WI
NPI
1114436326
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 17481)
Enumeration Date
2017-09-20
Last Update Date
2017-09-20
Business Address
TRACY M HUMPHRESS SAC-IT
3440 OAKWOOD HILLS PKWY
EAU CLAIRE, WI 54701-7698
Phone number: 715-214-2525
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Mailing Address
TRACY M HUMPHRESS SAC-IT
13287 44TH AVE
CHIPPEWA FALLS, WI 54729-7303
Phone number: 1715-703-0261
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