Individual
TRACY HIATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S. PPC
Contact information
Practice address
125 E PEARL AVE STE B005, JACKSON, WY 83001-8599
(307) 264-0161
Mailing address
PO BOX 2089, JACKSON, WY 83001-2089
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PPC-1214
WY
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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