Individual
TRACY L BAXLEY TULLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3106 W 2ND CT, SUITE 1, RUSSELLVILLE, AR 72801-4503
(479) 880-5100
(479) 880-5297
Mailing address
3106 W 2ND CT, SUITE 1, RUSSELLVILLE, AR 72801-4503
(479) 880-5100
(479) 880-5297
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2041C
AR
Other
Enumeration date
09/02/2006
Last updated
05/05/2015
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