Individual
TRACY KAY SPLITSTOSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCI
Contact information
Practice address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 452-1575
Mailing address
3830 S CUSHMAN ST, FAIRBANKS, AK 99701-7530
(907) 452-1575
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH0157
—
AK
Enumeration date
06/22/2010
Last updated
06/22/2010
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