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NPI Code Detail

MEDICARE: MRS. TRACEY LEIGH FLENIKEN LPC

MEDICARE:  MRS. TRACEY LEIGH FLENIKEN  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor18411TX

General Provider Information

NPI Number : 1295756229
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACEY LEIGH FLENIKEN LPC
Provider Business Mailing Address
First Line : PO BOX 173
Second Line :
City : SAINT JO
State : TX
Zip : 76265-0173
Country : US
Telephone Number : 469-387-9528
Fax Number :
Provider Business Practice Location Address
First Line : 115 N COMMERCE ST
Second Line :
City : GAINESVILLE
State : TX
Zip : 76240-3911
Country : US
Telephone Number : 940-665-8056
Fax Number : 940-665-8057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. TRACEY LEIGH FLENIKEN LPC” Practice Location

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