Individual
MS. DALE ELIZABETH TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
101 E CHESAPEAKE AVE, SUITE 202, TOWSON, MD 21286-5338
(410) 836-9622
(410) 836-9632
Mailing address
101 E CHESAPEAKE AVE, SUITE 202, TOWSON, MD 21286-5338
(410) 836-9622
(410) 836-9632
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCO 893
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1X84
BCBS PPO
MD
01
—
223697
COMPSYCH PROVIDER
MD
01
—
7183355
AETNA PROVIDER
MD
01
—
G5120001
BCBS DC PROVIDER
MD
Enumeration date
02/07/2007
Last updated
07/08/2007
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