| Doctor Name: | MRS. TRACI LYNN FEEK |
| NPI Number: | 1477823011 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NCSP, LPC |
| License Number: | |
| Business Practice Address: | 88 W Commerce Dr Suite C Hayden, ID - 838357994 |
| Business Phone Number: | 2087624405 |
| Business Fax Number: | |
| Mailing Address: | 88 W Commerce Dr, Suite C HAYDEN |
| State: | ID |
| Postal Code: | 838357994 |
| Phone Number: | 2087624405 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2012 |
| NPI Last Update Date: | 01/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |