Individual
DR. TRACIA KATHERINE LIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2001 PINE LAKE RD STE 200, LINCOLN, NE 68512-3604
(402) 261-8313
(402) 939-0437
Mailing address
2001 PINE LAKE RD STE 200, LINCOLN, NE 68512-3604
(402) 261-8313
(402) 939-0437
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
646
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA2109
MEDICARE ID
—
Enumeration date
10/11/2006
Last updated
10/30/2023
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