Individual
KERRI LEANNE TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6201 CORINTH RD, MT JULIET, TN 37122-7603
(760) 760-9636
Mailing address
6201 CORINTH RD, MT JULIET, TN 37122-7603
(760) 760-9636
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCS 23681
CA
1041C0700X
Clinical Social Worker
LSW628507
TN
Other
Enumeration date
08/24/2007
Last updated
05/25/2022
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