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General NPI Number Information
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NPI Number | 1205608676
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Entity Type | Organization
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Legal Business Name | TRACY PROTTI PHD PSYCHOLOGICAL AND CONSULTATIVE SERVICES
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 5619 BELMONT AVE APT 1307
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City | DALLAS
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State | TX
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Zip | 75206-6771
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Country | US
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Telephone | 662-487-6775
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Fax |
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Provider Business Mailing Address
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Address Line | 3014 DAUPHINE ST STE A
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City | NEW ORLEANS
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State | LA
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Zip | 70117-6755
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Country | US
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Telephone | 662-487-6775
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | TRACY PROTTI
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Credential | PH.D.
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Telephone | 662-487-6774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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