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1861746109
TRACIE DAVIS
WICHITA, KS
NPI
1861746109
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KS 701)
Enumeration Date
2012-11-08
Last Update Date
2012-11-08
Business Address
-- TRACIE DAVIS LAC
8911 E ORME ST SUITE A
WICHITA, KS 67207-2423
Phone number: 316-686-7884
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Mailing Address
-- TRACIE DAVIS LAC
8918 W 21ST ST N #200-284
WICHITA, KS 67205-1885
Phone number: 316-686-7884
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