| NPI | 1639726466 |
|---|---|
| Former Name | TRACEY ANN MCDOUGALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician (Licence: WA CG61002191) | |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2023-07-07 |