Individual
TRACIE JENNIFER STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
3900 W BROWN DEER RD, SUITE A, PMB 117, BROWN DEER, WI 53209
(414) 465-8101
Mailing address
3900 W BROWN DEER RD STE A, BROWN DEER, WI 53209-1220
(414) 465-8101
(414) 448-6944
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5793-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1194150037
—
WI
Enumeration date
09/11/2013
Last updated
07/25/2018
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