Individual
DR. TRACY JO DRAHOTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
9610 N METRO PKWY W, PHOENIX, AZ 85051-1402
(480) 964-2273
(602) 843-1560
Mailing address
3033 N CENTRAL AVE STE 145, PHOENIX, AZ 85012-2808
(623) 583-3001
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3289
OR
103TC0700X
Clinical Psychologist
Primary
PSY-004145
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500788403
—
OR
05
—
684311
—
AZ
01
—
Z327625
MEDICARE
AZ
Enumeration date
01/27/2011
Last updated
05/02/2025
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