| NPI | 1932443587 |
|---|---|
| Former Name | TRACIE ROGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2017-08-25 |