Individual
TRACY TAGACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., M.ED.
Contact information
Practice address
67-1232 KOALIULA PL, KAMUELA, HI 96743-8461
(808) 756-5696
Mailing address
PO BOX 6465, KAMUELA, HI 96743-6465
(808) 756-5696
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/01/2012
Last updated
09/25/2014
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