Individual
TRACY PORATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-4751
(715) 526-5542
Mailing address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-4751
(715) 526-5542
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/01/2015
Last updated
04/22/2015
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