Provider Demographics
NPI:1497962237
Name:HUCK, TRACY AMBER (BSW)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:AMBER
Last Name:HUCK
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NW 4TH ST STE B7
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47708-1355
Mailing Address - Country:US
Mailing Address - Phone:812-421-0059
Mailing Address - Fax:812-424-9059
Practice Address - Street 1:201 NW 4TH ST STE B7
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47708-1355
Practice Address - Country:US
Practice Address - Phone:812-421-0059
Practice Address - Fax:812-424-9059
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker