Individual
MS. TRACY A. LONGWILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPCC
Contact information
Practice address
11220 JORDAN AVE NE, ALBUQUERQUE, NM 87122-3383
(505) 828-2715
(505) 828-2715
Mailing address
11220 JORDAN AVE NE, ALBUQUERQUE, NM 87122-3383
(505) 828-2715
(505) 828-2715
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-0141521
NM
Other
Enumeration date
07/18/2011
Last updated
09/08/2014
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