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Individual
TRACY ANNE SHORT
Active
Individual
TRACY ANNE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PCC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
051023
OH
101YM0800X
Mental Health Counselor
C.0500234
OH
101YP2500X
Professional Counselor
Primary
C.0500234
OH
Other
Enumeration date
08/02/2010
Last updated
08/02/2010
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