| Doctor Name: | TRACY BLOOD |
| NPI Number: | 1013280015 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D |
| License Number: | 04991 |
| Business Practice Address: | 11120 New Hampshire Ave Suite # 204 Silver Spring, MD - 209042633 |
| Business Phone Number: | 3015931315 |
| Business Fax Number: | 3016814699 |
| Mailing Address: | 11120 New Hampshire Ave, Suite # 204 SILVER SPRING |
| State: | MD |
| Postal Code: | 20904 |
| Phone Number: | 3015931315 |
| Fax Number: | 3016814699 |
| NPI Enumeration Date: | 02/22/2012 |
| NPI Last Update Date: | 02/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 04991 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |