Healthcare Provider Details

I. General information

NPI: 1780753913
Provider Name (Legal Business Name): JENNIFER OZOLS TRACY PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OAK PLZ SUITE 206
ASHEVILLE NC
28801-3008
US

IV. Provider business mailing address

1 OAK PLZ STE 208
ASHEVILLE NC
28801-3000
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-2501
  • Fax: 828-252-2701
Mailing address:
  • Phone: 828-575-9760
  • Fax: 828-575-9761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number2452
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: