Doctor Name: | TRACEY CAUGHMAN |
NPI Number: | 1578806642 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 4985 |
Business Practice Address: | 204 N Ramage St Saluda, SC - 291381359 |
Business Phone Number: | 8644452968 |
Business Fax Number: | 8644459592 |
Mailing Address: | 204 N Ramage St, SALUDA |
State: | SC |
Postal Code: | 291381359 |
Phone Number: | 8644452968 |
Fax Number: | 8644459592 |
NPI Enumeration Date: | 03/27/2013 |
NPI Last Update Date: | 03/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 4985 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |