Individual
TRACI LOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15042 W SWEETWATER AVE, SURPRISE, AZ 85379-8164
(623) 523-8200
Mailing address
15042 W SWEETWATER AVE, SURPRISE, AZ 85379-8164
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
AZ
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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