Individual
TRACEY SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MFT INTERN
Contact information
Practice address
2517 N GREAT WESTERN DR STE L, PRESCOTT VALLEY, AZ 86314-2597
(623) 688-8201
Mailing address
PO BOX 4322, PRESCOTT, AZ 86302-4322
(928) 710-6860
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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