| Doctor Name: | MRS. TRACIE B SPENCER |
| NPI Number: | 1043301583 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 14797 |
| Business Practice Address: | 1100 Stone Road Suite 102 Behavioral Emotional Counseling Services Kilgore, TX - 756625494 |
| Business Phone Number: | 9039869114 |
| Business Fax Number: | 9039880243 |
| Mailing Address: | 1100 Stone Road, Suite 102 KILGORE |
| State: | TX |
| Postal Code: | 756625494 |
| Phone Number: | 9039869114 |
| Fax Number: | 9039880243 |
| NPI Enumeration Date: | 09/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 14797 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |