Individual
TRACI ROGERS FUQUAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
118 NEW STATESIDE DR, CHAPEL HILL, NC 27516-1165
(919) 442-1840
Mailing address
104 NEW STATESIDE DR, CHAPEL HILL, NC 27516-1165
(919) 942-2803
(919) 942-2126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-21219
NC
Other
Enumeration date
10/05/2016
Last updated
10/05/2016
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