Doctor Name: | TRACEY L JOHNSON |
NPI Number: | 1124168877 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 61252 |
Business Practice Address: | 6009 Squire Ct #1 Memphis, TN - 381153226 |
Business Phone Number: | 9013969007 |
Business Fax Number: | |
Mailing Address: | 2946 Covington Pike, Pmb 162 MEMPHIS |
State: | TN |
Postal Code: | 381286007 |
Phone Number: | 9013969007 |
Fax Number: | |
NPI Enumeration Date: | 02/08/2007 |
NPI Last Update Date: | 09/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 61252 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
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 |