Individual provider · Type 1 NPI

Jessica Tracy, LAC

Professional Counselor · Glendale, AZ

NPI number 1154960250 Active

Practice location

21448 N 75th Ave Ste 6
Glendale, AZ 85308-5978

Call (940) 631-2629 Map

Mailing address

13421 N 43rd Ave Apt 3095
Phoenix, AZ 85029-1042

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X18662 (AZ)

Professional Counselor: Definition to come...

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About NPI 1154960250

Jessica Tracy, LAC's National Provider Identifier is 1154960250, issued on Jan 6, 2020. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Glendale, AZ. The record was last updated on Jan 6, 2020.