Individual
TRACIE LYNN PURNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
121 W. LOOCKERMAN, DOVER, DE 19904
(302) 674-1397
Mailing address
707 WEST 13TH STREET, NEW CASTLE, DE 19720
(302) 598-1129
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW017452
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CW017452
COMMONWEALTH OF PENNSYLVANIA
PA
Enumeration date
01/03/2013
Last updated
01/03/2013
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