| NPI | 1730885377 |
|---|---|
| Former Name | TRACY LONSDORF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NC C016284) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: VA 0904014844) |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2024-08-19 |