| Doctor Name: | MS. TRACY JENIFER FAUST |
| NPI Number: | 1326006230 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., LPC, SAC, NCC |
| License Number: | 13199 |
| Business Practice Address: | 3900 W Brown Deer Rd Ste 200 Brown Deer, WI - 532091220 |
| Business Phone Number: | 4145402170 |
| Business Fax Number: | 4145402171 |
| Mailing Address: | 3292 Davies Ave, GREEN BAY |
| State: | WI |
| Postal Code: | 543117200 |
| Phone Number: | 4145402170 |
| Fax Number: | 4145402171 |
| NPI Enumeration Date: | 05/02/2006 |
| NPI Last Update Date: | 09/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 13199 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |