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Individual
KAREN TRACY COLLICA
Active
Individual
KAREN TRACY COLLICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
822126
CA
363L00000X
Nurse Practitioner
Primary
95007559
CA
Other
Enumeration date
04/16/2013
Last updated
11/13/2017
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