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Individual
TRACY DENISE TRUMP
Active
Individual
TRACY DENISE TRUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12-P-10
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
22-QMHA-R-2116
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5494176
ODL
OR
Enumeration date
02/08/2016
Last updated
11/23/2022
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