Individual
TRACY ROBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3150 CARLISLE BLVD NE STE 110, ALBUQUERQUE, NM 87110-1681
(505) 255-7686
Mailing address
3150 CARLISLE BLVD NE STE 110, ALBUQUERQUE, NM 87110-1681
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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