| Doctor Name: | TRACY TAGACA |
| NPI Number: | 1407100100 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., M.ED. |
| License Number: | |
| Business Practice Address: | 67-1232 Koaliula Pl Kamuela, HI - 967438461 |
| Business Phone Number: | 8087565696 |
| Business Fax Number: | |
| Mailing Address: | Po Box 6465, KAMUELA |
| State: | HI |
| Postal Code: | 967436465 |
| Phone Number: | 8087565696 |
| Fax Number: | |
| NPI Enumeration Date: | 11/01/2012 |
| NPI Last Update Date: | 09/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |