Individual
TRACY RALICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
120 BASELINE RD, SOUTH HAVEN, MI 49090-1037
(269) 637-8411
Mailing address
120 BASELINE RD, SOUTH HAVEN, MI 49090-1037
(269) 637-8411
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
5201000385
MI
Other
Enumeration date
03/31/2018
Last updated
03/31/2018
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