Provider Demographics
NPI:1881667020
Name:TODD, TRACY A (PHD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:A
Last Name:TODD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8791 WOLFF CRT
Mailing Address - Street 2:#130
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80030-3684
Mailing Address - Country:US
Mailing Address - Phone:303-426-8757
Mailing Address - Fax:303-426-1390
Practice Address - Street 1:8791 WOLFF CRT
Practice Address - Street 2:#130
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80030-3684
Practice Address - Country:US
Practice Address - Phone:303-426-8757
Practice Address - Fax:303-426-1390
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO069106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist