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Individual

TRACY FEY BLACKSTONE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CRC, LPC, ASDCS

Contact information

Practice address
2940 CHAPEL VALLEY RD STE 2, FITCHBURG, WI 53711-6451
(608) 504-3600
Mailing address
901 S WHITNEY WAY, MADISON, WI 53711-2553

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10458125
WI
225C00000X
Rehabilitation Counselor
WI

Other

Enumeration date
10/21/2021
Last updated
03/28/2024
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