Provider Demographics
NPI:1417027467
Name:ALLRED, TRACY L (EDD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:L
Last Name:ALLRED
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:685 EMORY VALLEY ROAD
Mailing Address - Street 2:SUITE C
Mailing Address - City:OAKRIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830
Mailing Address - Country:US
Mailing Address - Phone:865-482-9252
Mailing Address - Fax:
Practice Address - Street 1:685 EMORY VALLEY ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:OAKRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830
Practice Address - Country:US
Practice Address - Phone:865-482-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002330103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling