Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LW00008268 | WA |
NPI | 1003073743 |
---|---|
Provider Name | Mrs. Tracey Hunt |
First Address | Tacoma, WA 98422-3259 |
Second Address | Tacoma, WA 98422-3259 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 20/05/2008 |