Provider Demographics
NPI:1750891875
Name:GRABB, TRACI LYNN (LPC)
Entity type:Individual
Prefix:MS
First Name:TRACI
Middle Name:LYNN
Last Name:GRABB
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:TRACI
Other - Middle Name:LYNN
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6280 E PIMA ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3074
Mailing Address - Country:US
Mailing Address - Phone:520-329-1250
Mailing Address - Fax:520-344-7687
Practice Address - Street 1:6280 E PIMA ST STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3074
Practice Address - Country:US
Practice Address - Phone:520-329-1250
Practice Address - Fax:520-344-7687
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16523101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional