Tippett, Traci Leanne

Tippett, Traci Leanne is an sole proprietor health care provider with primary practice located at 836 W 1St North St , Morristown TN 37814-4548. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Tippett, Traci Leanne can be contacted via phone (423) 581-5342.

Contact Information

Primary practice address
836 W 1St North St Morristown TN 37814-4548
Phone: (423) 581-5342
Fax: (423) 581-8650
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X LSW3620 Tennessee
Behavioral Health & Social Service Providers / Clinical 1041C0700X I-07410 New Mexico

Profile Details

NPI number 1184622383
LBN Legal business name Tippett, Traci Leanne
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 12th, 2005
Last updated Jun 19th, 2014 - about 11 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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Identifiers

StateTypeNumberIssuer
All States NPI 1184622383 NPPES
Tennessee MEDICAID 3922967

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