Individual
MRS. TRACY SUE EINWICH-BRIDOUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
160 N BEACH ST, DAYTONA BEACH, FL 32114, DAYTONA BEACH, FL 32114-3314
(386) 944-4707
(386) 868-2569
Mailing address
160 N BEACH ST, DAYTONA BEACH, FL 32114, DAYTONA BEACH, FL 32114-3314
(386) 341-6789
(386) 868-2569
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E521817675960
FLORIDA DRIVERS LICENSE NUMBER
—
Enumeration date
08/10/2012
Last updated
08/10/2012
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