| NPI | 1699138800 |
|---|---|
| Former Name | TRACY JOSEPH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR c4170) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180010136) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-09-13 |