ELLEN MARIE TRACY

KETCHUM, ID
NPI1629290531
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy106H00000X Marriage & Family Therapist
(Licence: ID  LMFT-3837)
Additional Taxonomies106H00000X Marriage & Family Therapist
(Licence: CA  MFC-30249)
Enumeration Date2007-05-02
Last Update Date2007-07-08
Business Address
-- ELLEN MARIE TRACY MFT
110 FIFTH ST STE. 103
KETCHUM, ID 83353
Phone number: 208-720-7868
Mailing Address
-- ELLEN MARIE TRACY MFT
PO BOX 6282
SUN VALLEY, ID 83354
Phone number: 208-720-7868