Individual
DIANA LYNN TRACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8101 HINSON FARM RD, SUITE 117, ALEXANDRIA, VA 22306-3403
(571) 245-0054
Mailing address
4108 OLD MILL RD, ALEXANDRIA, VA 22309-2817
(703) 780-9385
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904002539
VA
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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