| NPI | 1669515193 |
|---|---|
| Former Name | TRACY LYNN CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 91807) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 4166) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2025-07-16 |