Individual
TRACEY MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1406 CRAIN HWY S STE 104, GLEN BURNIE, MD 21061-4086
(410) 766-6624
Mailing address
1406 CRAIN HWY S STE 104, GLEN BURNIE, MD 21061-4086
(410) 766-6624
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LC8066
MD
101YP2500X
Professional Counselor
Primary
LC8066
MD
Other
Enumeration date
08/22/2017
Last updated
07/21/2022
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