Individual
MRS. BOBBIE LYNN TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
SOUTHWEST HIGHLAND DRIVE, CROWNPOINT, NM 87313
(505) 786-2111
(505) 786-2020
Mailing address
SOUTHWEST HIGHLAND DRIVE, CROWNPOINT, NM 87313
(505) 786-2111
(505) 786-2020
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0120661
NM
Other
Enumeration date
10/09/2009
Last updated
10/09/2009
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