Individual
MISS TRACY LENORA COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CEO
Contact information
Practice address
10537 S CRATER RD, SOUTH PRINCE GEORGE, VA 23805-7333
(757) 637-8764
(804) 895-6884
Mailing address
PO BOX 6015, PETERSBURG, VA 23805-6015
(757) 637-8764
(804) 895-6884
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1912
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912
—
VA
Enumeration date
05/30/2013
Last updated
05/30/2013
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