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TRACY TAYLOR LPC

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1215030374

Individual Registrant:
 TRACY  TAYLOR LPC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
11EAGLE DR.  VILONIA, AR 72173 US
Tel: 501-412-4529  Fax: --

Contact information for business:
1 WHIPPOORWILL DR  VILONIA, AR 72173-9229 US
Tel: --  Fax: --

Registration Information:
NPI: 1215030374
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
ARP0210044

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
BCBS5Y548AR01




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