| NPI | 1326679556 |
|---|---|
| Other Name | TEDDY TRACY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178019260) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: IL 178019260) |
| 101YM0800X Counselor, Mental Health | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2026-09-23 |