Provider Demographics
NPI:1083908115
Name:MULLER, TRACY ANN (MA LIMHP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:MULLER
Suffix:
Gender:F
Credentials:MA LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ANN ST
Mailing Address - Street 2:PO BOX 73
Mailing Address - City:MORSE BLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:68648-4890
Mailing Address - Country:US
Mailing Address - Phone:402-720-7206
Mailing Address - Fax:
Practice Address - Street 1:2170 N PLATTE AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2630
Practice Address - Country:US
Practice Address - Phone:402-720-7206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9404101YM0800X
NE1651101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health