Individual
TRACY ROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 SOUTH ST FL 2NF, WEST HARTFORD, CT 06110-1967
(860) 578-1300
Mailing address
10 YEOMANS RD, COLUMBIA, CT 06237-1533
(860) 942-9666
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/15/2018
Last updated
06/16/2018
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