Individual provider · Type 1 NPI

Tracy L. Pederson, LCDCIII, SWA

Addiction (Substance Use Disorder) Counselor · Waverly, OH

NPI number 1134624943 Active

Practice location

102 Dawn Ln
Waverly, OH 45690-9695

Call (740) 947-7783 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X161646 (OH)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1134624943

Tracy L. Pederson, LCDCIII, SWA's National Provider Identifier is 1134624943, issued on Mar 26, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Waverly, OH. The record was last updated on Mar 26, 2018.