Healthcare Provider Details

I. General information

NPI: 1174326631
Provider Name (Legal Business Name): TRACEY SAXON NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2025
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 KINGS HWY STE 1A
MILFORD CT
06460-8023
US

IV. Provider business mailing address

123 KINGS HWY STE 1A
MILFORD CT
06460-8023
US

V. Phone/Fax

Practice location:
  • Phone: 845-548-6188
  • Fax:
Mailing address:
  • Phone: 203-693-0486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: