Provider Demographics
NPI:1376883868
Name:LEET, TRACY LYNN (MA)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:LYNN
Last Name:LEET
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:230 MOUNT HOPE ST
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-1714
Mailing Address - Country:US
Mailing Address - Phone:814-807-0861
Mailing Address - Fax:814-807-0863
Practice Address - Street 1:435 CHESTNUT ST
Practice Address - Street 2:PARKSIDE PSYCHOLOGICAL ASSOCIATES, LLC
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-4404
Practice Address - Country:US
Practice Address - Phone:814-807-0861
Practice Address - Fax:814-807-0863
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical