| Doctor Name: | TRACIE D SUMBLER |
| NPI Number: | 1154620599 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ABA THERAPIST |
| License Number: | 340066BN |
| Business Practice Address: | 500 Fairway Dr Suite 102 Deerfield Bch, FL - 334411814 |
| Business Phone Number: | 8888809270 |
| Business Fax Number: | |
| Mailing Address: | 500 Fairway Dr, Suite 102 DEERFIELD BCH |
| State: | FL |
| Postal Code: | 334411814 |
| Phone Number: | 8008809270 |
| Fax Number: | |
| NPI Enumeration Date: | 03/24/2011 |
| NPI Last Update Date: | 08/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 340066BN |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |