| Doctor Name: | TRACY ANNE SHORT |
| NPI Number: | 1891009866 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PCC |
| License Number: | 051023 |
| Business Practice Address: | 2700 E Main St Bexley, OH - 432092536 |
| Business Phone Number: | 6142358832 |
| Business Fax Number: | 6142358864 |
| Mailing Address: | 297 Crestview Rd, COLUMBUS |
| State: | OH |
| Postal Code: | 432022209 |
| Phone Number: | 6142640601 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2010 |
| NPI Last Update Date: | 08/02/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 051023 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |