Individual
TRACI SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2626 ST JOE CENTER RD, FORT WAYNE, IN 46825-2311
(260) 497-0328
Mailing address
2626 ST JOE CENTER RD, FORT WAYNE, IN 46825-3880
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/01/2020
Last updated
06/26/2023
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