Individual
MS. TRACY DIANE TACQUARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1504 PEBBLE BAY CT, GRANBURY, TX 76048-1238
(951) 764-0537
(951) 848-9416
Mailing address
1504 PEBBLE BAY CT, GRANBURY, TX 76048-1238
(951) 764-0537
(951) 848-9416
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFC38834
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154471530
OUTPATIENT MENTAL HEALTH
TX
Enumeration date
01/10/2007
Last updated
02/07/2024
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