Individual
TRACIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
8911 E ORME ST, SUITE A, WICHITA, KS 67207-2423
(316) 686-7884
(316) 686-0036
Mailing address
8918 W 21ST ST N, #200-284, WICHITA, KS 67205-1885
(316) 686-7884
(316) 686-0036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
701
KS
Other
Enumeration date
11/08/2012
Last updated
11/08/2012
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