Organization
TRACY P SMITH MA LICENSED PSYCHOLOGIST PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRACY PAULEY SMITH MA (LICENSED PSYCHOLOGIST/OWNER)
(304) 539-6222
Entity
Organization
Contact information
Practice address
21 CHEROKEE TRL, ELKVIEW, WV 25071-9263
(304) 965-0372
(304) 965-0372
Mailing address
1511 RAMBLER RD, CHARLESTON, WV 25314-1830
(304) 539-6222
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
785
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9205040000
—
WV
Enumeration date
10/02/2009
Last updated
06/16/2014
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