Individual
MS. DENNISE LINDA TRAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., LCSW
Contact information
Practice address
255 MOBILE DR, ASHLAND, OR 97520-9021
(541) 488-2264
Mailing address
255 MOBILE DR, ASHLAND, OR 97520-9021
(541) 488-2264
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4083
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R160516
MEDICARE PTAN
—
Enumeration date
02/19/2007
Last updated
08/06/2015
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