Individual
TRACY ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
908A W CHANDLER BLVD, CHANDLER, AZ 85225-4903
(480) 899-0200
Mailing address
908A W CHANDLER BLVD, CHANDLER, AZ 85225-4903
(480) 899-0200
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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