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General NPI Number Information
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NPI Number | 1285757500
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Entity Type | Organization
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Legal Business Name | JILL E. TRAGER, PSY.D.
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2719 ASHMAN ST
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City | MIDLAND
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State | MI
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Zip | 48640-4434
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Country | US
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Telephone | 989-832-1884
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Fax |
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Provider Business Mailing Address
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Address Line | 2719 ASHMAN ST
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City | MIDLAND
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State | MI
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Zip | 48640-4434
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Country | US
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Telephone | 989-832-1884
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Fax |
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Authorized Official
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Title or Position | PSLYCHOLOGIST-SOLE PROPRIETOR
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Name | DR. JILL E. TRAGER
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Credential | PSY.D.
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Telephone | 989-832-1884
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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 | 009739
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License Number State | MI
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