Shoemaker, Tracey
Shoemaker, Tracey is an sole proprietor health care provider with primary practice located at 1485 81St Ave Ne , Spring Lake Park MN 55432-2111. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Shoemaker, Tracey can be contacted via phone (763) 780-3036.Contact Information
Primary practice address
1485 81St Ave Ne
Spring Lake Park MN 55432-2111
Phone: (763) 780-3036
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP3750 | Minnesota |
Profile Details
| NPI number | 1902902323 |
|---|---|
| LBN Legal business name | Shoemaker, Tracey |
| Credentials | MA, LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902902323 | NPPES |
| Minnesota | Other | 62-22415 | MEDICA |
| Minnesota | Other | 5483166-00 | MEDICA |
| Minnesota | Other | 61D95SH | MEDICA |
| Minnesota | Other | HP27880 | MEDICA |
| Minnesota | Other | 108248 | MEDICA |
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