Provider Demographics
NPI:1780267286
Name:TORMES, TRACY LYNN (BCBA)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:LYNN
Last Name:TORMES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 SHAWNEE MISSION PKWY
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202-4005
Mailing Address - Country:US
Mailing Address - Phone:888-913-1910
Mailing Address - Fax:
Practice Address - Street 1:6901 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202-4005
Practice Address - Country:US
Practice Address - Phone:888-913-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021015486103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst