| Doctor Name: | TRACY DAWN CHASE |
| NPI Number: | 1043591464 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 65127 |
| Business Practice Address: | 6502 Nursery Dr Suite 100 Victoria, TX - 779041178 |
| Business Phone Number: | 3615750611 |
| Business Fax Number: | 3615282327 |
| Mailing Address: | 6502 Nursery Dr, Suite 100 VICTORIA |
| State: | TX |
| Postal Code: | 779041178 |
| Phone Number: | 3615750611 |
| Fax Number: | 3615282327 |
| NPI Enumeration Date: | 08/30/2011 |
| NPI Last Update Date: | 08/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 65127 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |