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Individual
TRACY HAZAN BOUSQUET
Active
Individual
TRACY HAZAN BOUSQUET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
094756
NY
1041C0700X
Clinical Social Worker
44SL06560300
NJ
Other
Enumeration date
10/23/2020
Last updated
10/29/2020
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