Individual
LESLIE TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
109 N 4TH ST, SUITE 201, HAMILTON, MT 59840-2401
(406) 370-5439
Mailing address
338 WHISPERING WILLOW WAY, CORVALLIS, MT 59828-9316
(406) 370-5439
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1400
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477745370
—
MT
Enumeration date
05/07/2009
Last updated
08/10/2016
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