Doctor Name: | MISS TRACY R ISHMAEL |
NPI Number: | 1922433317 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA |
License Number: | |
Business Practice Address: | 3041 Getwell Rd Memphis, TN - 381183737 |
Business Phone Number: | 9013751050 |
Business Fax Number: | 9013751588 |
Mailing Address: | 5100 Cottonwood Rd, MEMPHIS |
State: | TN |
Postal Code: | 381182622 |
Phone Number: | 9012057869 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2013 |
NPI Last Update Date: | 09/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |