| NPI | 1245619907 |
|---|---|
| Former Name | TRACY STUETTGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5702) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 1903-226) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2018-08-29 |