Individual
TRACY THURSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MC, LPC
Contact information
Practice address
3540 E BASELINE RD STE 150, PHOENIX, AZ 85042-9630
(602) 323-3000
Mailing address
202 E EARLL DR STE 200, PHOENIX, AZ 85012-2647
(602) 808-2800
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-12198
AZ
Other
Enumeration date
07/31/2012
Last updated
02/26/2019
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