Individual
BRENDA ANN TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
219 W MAGNOLIA ST, FORT COLLINS, CO 80521-2811
(307) 460-0385
Mailing address
1910 COUNTY ROAD 82E, LIVERMORE, CO 80536-9213
(307) 460-0385
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4814
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4814
LICENSED PROFESSIONAL COUNSELOR
CO
Enumeration date
07/05/2011
Last updated
08/07/2013
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