Wilson, Tracy C

Wilson, Tracy C is an individual health care provider with primary practice located at 215 Bradley St , Carrollton GA 30117-3217. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Wilson, Tracy C can be contacted via phone (770) 832-9140.

Contact Information

Primary practice address
215 Bradley St Carrollton GA 30117-3217
Phone: (770) 832-9140
Fax: (770) 832-3046
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2748 Georgia

Profile Details

NPI number 1033256938
LBN Legal business name Wilson, Tracy C
Credentials Master of Education (MED)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Nov 11th, 2009 - about 15 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 1033256938 NPPES
Georgia MEDICAID 844101180A
Georgia Other 11643300

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