| Doctor Name: | TRACY L ANDERSON |
| NPI Number: | 1104022029 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 6401010067 |
| Business Practice Address: | 1100 Ludington St Suite 401 Escanaba, MI - 498293542 |
| Business Phone Number: | 9067891596 |
| Business Fax Number: | 9067892024 |
| Mailing Address: | 1100 Ludington St Ste 401, ESCANABA |
| State: | MI |
| Postal Code: | 498293545 |
| Phone Number: | 9067891596 |
| Fax Number: | 9067892024 |
| NPI Enumeration Date: | 06/26/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6401010067 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |