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General NPI Number Information
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NPI Number | 1194261701
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Entity Type | Organization
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Legal Business Name | TRACI KOEN, LPC-S, PLLC
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 5601 DEMOCRACY DR SUITE 135
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City | PLANO
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State | TX
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Zip | 75024-3687
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Country | US
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Telephone | 214-478-0314
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 CROWN KNOLL LN
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City | PLANO
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State | TX
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Zip | 75093-4101
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Country | US
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Telephone | 214-478-0314
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Fax |
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Authorized Official
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Title or Position | OWNER, THERAPIST
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Name | MRS. TRACI D. KOEN
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Credential | LPC-S, NCC
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Telephone | 214-478-0314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 63092
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License Number State | TX
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