Healthcare Provider Details

I. General information

NPI: 1851633838
Provider Name (Legal Business Name): TRACY HARPER DOSSETT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRACY ANN HARPER J.D.

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10641 HILLARY CT SUITE 1
BATON ROUGE LA
70810-2979
US

IV. Provider business mailing address

10641 HILLARY CT SUITE 1
BATON ROUGE LA
70810-2979
US

V. Phone/Fax

Practice location:
  • Phone: 225-387-3325
  • Fax: 225-387-0140
Mailing address:
  • Phone: 225-387-3325
  • Fax: 225-387-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1230
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: