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General NPI Number Information
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NPI Number | 1790153112
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Entity Type | Individual
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Provider Name | TRACY L THOMAS PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 02/18/2023
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Provider Practice Location Address
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Address Line | 1200 G ST NW SUITE 800
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City | WASHINGTON
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State | DC
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Zip | 20005-3814
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Country | US
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Telephone | 202-810-4518
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Fax |
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Provider Business Mailing Address
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Address Line | 555 MASSACHUSETTS AVE NW APT 808
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City | WASHINGTON
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State | DC
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Zip | 20001-4721
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Country | US
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Telephone | 202-486-8868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PSY1000964
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License Number State | DC
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