Individual
TRACY DAWN GARZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
12621 ZUNI ST APT 17-102, BROOMFIELD, CO 80020-3806
(719) 924-2443
Mailing address
12621 ZUNI ST APT 17-102, BROOMFIELD, CO 80020-3806
(719) 924-2443
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
MI-4601
CO
376K00000X
Nurse's Aide
NA-365660
CO
Other
Enumeration date
01/19/2012
Last updated
01/19/2012
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