Tracy Ralicki
Occupational Therapist - Gerontology
120 Baseline Rd
South Haven
, Michigan 49090-1037
Tracy Ralicki
Occupational Therapist - Gerontology
120 Baseline Rd
South Haven
, Michigan 49090-1037
(269) 637-8411
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About
Features
Specialties
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Tracy Ralicki
- 120 Baseline Rd
- South Haven, MI
- Zip : 49090-1037
- Phone : (269) 637-8411
Second Address
- Tracy Ralicki
- 120 Baseline Rd
- South Haven, MI
- Zip : 49090-1037
- Phone : (269) 637-8411
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XG0600X | Occupational Therapist - Gerontology | 5201000385 | MI |
National Provider Identifier
| NPI | 1659877512 |
|---|---|
| Provider Name | Tracy Ralicki |
| First Address | South Haven, MI 49090-1037 |
| Second Address | South Haven, MI 49090-1037 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 31/03/2018 |
| Last Update Date | 31/03/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.