| Doctor Name: | LESLIE TRACEY |
| NPI Number: | 1073747895 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 1400 |
| Business Practice Address: | 55 Basin Creek Rd Butte, MT - 597019704 |
| Business Phone Number: | 4064966314 |
| Business Fax Number: | 4064941724 |
| Mailing Address: | Po Box 1072, THREE FORKS |
| State: | MT |
| Postal Code: | 597521072 |
| Phone Number: | 4062553316 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2009 |
| NPI Last Update Date: | 05/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |