Provider Demographics
NPI:1225556202
Name:GILBERT, TRACY
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-2421
Mailing Address - Country:US
Mailing Address - Phone:318-878-6696
Mailing Address - Fax:
Practice Address - Street 1:712 FIRST ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-2421
Practice Address - Country:US
Practice Address - Phone:318-878-6696
Practice Address - Fax:318-878-6698
Is Sole Proprietor?:No
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health