Bush, Tracie L

Bush, Tracie L is an individual health care provider with primary practice located at 79 Country Way , Madison CT 06443-1759. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Bush, Tracie L can be contacted via phone (203) 848-7169.

Contact Information

Primary practice address
79 Country Way Madison CT 06443-1759
Phone: (203) 848-7169
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X

Profile Details

NPI number 1043689011
LBN Legal business name Bush, Tracie L
Credentials M.A., CKPMT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2015
Last updated Sep 21st, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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