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Individual

TRACY LYNETT MITCHELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
22365 BARTON RD STE 302, GRAND TERRACE, CA 92313-5078
(951) 653-6958
Mailing address
PO BOX 1170, MORENO VALLEY, CA 92556-1170
(951) 653-6958

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
03/22/2024
Last updated
03/22/2024
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