Individual
TRACY DOERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPCC/LADC
Contact information
Practice address
10464 HOLLYWOOD BLVD NW, COON RAPIDS, MN 55433-4517
(612) 900-8934
Mailing address
10464 HOLLYWOOD BLVD NW, COON RAPIDS, MN 55433-4517
(612) 900-8934
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303832
MN
101YM0800X
Mental Health Counselor
Primary
3801
MN
101YP2500X
Professional Counselor
3801
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N204188757206
—
MN
Enumeration date
08/27/2021
Last updated
02/20/2024
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