Individual
TRACEY Y HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS BEHAVIORAL SERV,
Contact information
Practice address
205 STOREY BLVD STE 120, CHEYENNE, WY 82009-3566
(307) 459-6160
Mailing address
301 E 21ST ST APT BSMT, CHEYENNE, WY 82001-3761
(307) 275-5981
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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