Doctor Name: | TRACY LYNN ROE |
NPI Number: | 1104059054 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., L.C.P.C., NCC |
License Number: | 18781 |
Business Practice Address: | 14 Homestead Ct Boise, ID - 837163250 |
Business Phone Number: | 2083929342 |
Business Fax Number: | |
Mailing Address: | 14 Homestead Ct, BOISE |
State: | ID |
Postal Code: | 837163250 |
Phone Number: | 2083929342 |
Fax Number: | |
NPI Enumeration Date: | 08/26/2009 |
NPI Last Update Date: | 03/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 18781 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |