| NPI | 1528252004 |
|---|---|
| Former Name | TRACI S TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NE 3742) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 8425) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2019-08-20 |