Individual
TRACEY L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6009 SQUIRE CT, #1, MEMPHIS, TN 38115-3226
(901) 396-9007
Mailing address
2946 COVINGTON PIKE, PMB 162, MEMPHIS, TN 38128-6007
(901) 396-9007
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
61252
TN
101YP2500X
Professional Counselor
Primary
2331
TN
Other
Enumeration date
02/08/2007
Last updated
09/04/2008
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