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Individual

TRACI TOLLIVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LMFT, LMHC, CMHS

Contact information

Practice address
106 PLAZA DR SE BLDG B3, YELM, WA 98597-8841
(253) 249-5991
(360) 507-8097
Mailing address
21543 W TERRA LN SE, YELM, WA 98597-9027
(253) 249-5991
(360) 507-8097

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60749833
WA
106H00000X
Marriage & Family Therapist
Primary
LF60890982
WA

Other

Enumeration date
02/28/2014
Last updated
08/09/2020
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