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TRACY TAYLOR LPC
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1215030374
Individual Registrant: TRACY TAYLOR LPC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
11EAGLE DR. VILONIA, AR 72173 US
Tel: 501-412-4529 Fax: --
Tel: 501-412-4529 Fax: --
Contact information for business:
1 WHIPPOORWILL DR VILONIA, AR 72173-9229 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1215030374
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health | AR | P0210044 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| BCBS | 5Y548 | AR | 01 |
