Individual
DR. TRACY LEIGH CHISHOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
22400 JOHNSON RD, WEST LINN, OR 97068-9722
(850) 294-5733
Mailing address
22400 JOHNSON RD, WEST LINN, OR 97068-9722
(850) 294-5733
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001273
IA
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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