Individual
TRACEY G. HENLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY D
Contact information
Practice address
4720 CLEVELAND HEIGHTS BLVD STE 105, LAKELAND, FL 33813-2244
(863) 701-9202
(863) 701-9292
Mailing address
4720 CLEVELAND HEIGHTS BLVD STE 105, LAKELAND, FL 33813-2244
(863) 701-9202
(863) 701-9292
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY6020
FL
Other
Enumeration date
12/12/2006
Last updated
06/05/2008
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