Individual
DR. TRACEY MOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655
(508) 334-2731
(774) 442-4672
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
01233
RI
103T00000X
Psychologist
9384
MA
103TC0700X
Clinical Psychologist
Primary
9384
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110114001A
—
MA
Enumeration date
10/23/2008
Last updated
12/02/2020
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