| Tracy Davis, Lmft, Llc | |
|
11812 Wayzata Blvd Ste 200b Minnetonka MN 55305-2012 | |
| (612) 293-5823 | |
| Not Available |
| Full Name | Tracy Davis, Lmft, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 11812 Wayzata Blvd Ste 200b, Minnetonka, Minnesota |
| Authorized Official Name and Position | Tracy Davis (OWNER) |
| Authorized Official Contact | 6122935823 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tracy Davis, Lmft, Llc 11812 Wayzata Blvd Ste 200b Minnetonka MN 55305-2012 Ph: (612) 293-5823 | Tracy Davis, Lmft, Llc 11812 Wayzata Blvd Ste 200b Minnetonka MN 55305-2012 Ph: (612) 293-5823 |
| NPI Number | 1497578439 |
|---|---|
| Provider Enumeration Date | 11/07/2024 |
| Last Update Date | 11/07/2024 |
| Certification Date | 11/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497578439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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