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General NPI Number Information
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NPI Number | 1790926004
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Entity Type | Individual
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Provider Name | MARGARET E. TRACY LLC
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Gender | Female
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 225 S MERAMEC AVE STE 310
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City | CLAYTON
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State | MO
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Zip | 63105-3511
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Country | US
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Telephone | 314-727-0097
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Fax | 314-862-6009
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Provider Business Mailing Address
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Address Line | 225 S MERAMEC AVE STE 310
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City | CLAYTON
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State | MO
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Zip | 63105-3511
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Country | US
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Telephone | 314-727-0097
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Fax | 314-862-6009
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 000150
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 000150
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License Number State | MO
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