Individual
MS. TRACINE RENEE HALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LEP
Contact information
Practice address
401 19TH ST, BAKERSFIELD, CA 93301-4907
(661) 873-5110
Mailing address
7401 HILTON HEAD WAY UNIT 27, BAKERSFIELD, CA 93309-4223
(661) 873-5110
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
3148
CA
103TB0200X
Cognitive & Behavioral Psychologist
3148
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3148
CA
103TS0200X
School Psychologist
Primary
3148
CA
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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