| NPI | 1568644359 |
|---|---|
| Former Name | TRACEY SHEAMAN SWOPE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC007191) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA 1317) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2019-06-24 |