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Individual
TRACY RENEE ADEVAI
Active
Individual
TRACY RENEE ADEVAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
L10899
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500685947
—
OR
Enumeration date
07/25/2014
Last updated
03/02/2024
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