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1740786706
TRACEY LEE PUCKETT
COLUMBUS, OH
NPI
1740786706
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 130994)
Enumeration Date
2018-03-30
Last Update Date
2018-03-30
Business Address
Mr. TRACEY LEE PUCKETT CDCA, QMHS, BA
899 E BROAD ST # 110
COLUMBUS, OH 43205-1156
Phone number: 614-220-8655
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Mailing Address
Mr. TRACEY LEE PUCKETT CDCA, QMHS, BA
235 DEAN LN
FRANKFORT, OH 45628-9626
Phone number: 740-981-7546
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