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Individual

ASHLEY N TRACY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
41945 BIG BEAR BLVD., SUITE 208, BIG BEAR LAKE, CA 92315
(909) 878-0101
Mailing address
PO BOX 6070, BIG BEAR LAKE, CA 92315-6070

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
02/09/2011
Last updated
02/09/2011
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