Individual
AMANDA TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4989 N 3RD ST, LARAMIE, WY 82072-9548
(307) 745-8997
Mailing address
4989 N 3RD ST, LARAMIE, WY 82072-9548
(307) 745-8997
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PPP-1401
WY
172V00000X
Community Health Worker
—
—
Other
Enumeration date
01/13/2020
Last updated
07/14/2023
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