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Individual

DR. TRACY DWIGHT EELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
401 E CHESTNUT ST UNIT 610, LOUISVILLE, KY 40202-5711
(502) 588-4450
(502) 588-9539
Mailing address
401 E CHESTNUT ST UNIT 600, LOUISVILLE, KY 40202-5705
(502) 588-4425
(502) 588-4427

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
KY00839
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
402278
TRICARE
KY
Enumeration date
02/02/2006
Last updated
01/14/2019
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