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Individual
TRACY L BANE
Active
Individual
TRACY L BANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW6953
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z057A
BLUE SHIELD NUMBER
FL
Enumeration date
05/05/2006
Last updated
01/24/2019
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