Provider Demographics
NPI:1780352211
Name:STEELE, TRACY RAE
Entity type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:RAE
Last Name:STEELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 CYPRESS CIRCLE LN
Mailing Address - Street 2:
Mailing Address - City:HOLMEN
Mailing Address - State:WI
Mailing Address - Zip Code:54636-7310
Mailing Address - Country:US
Mailing Address - Phone:218-201-0613
Mailing Address - Fax:
Practice Address - Street 1:402 S BLACK RIVER ST STE 125
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656-2043
Practice Address - Country:US
Practice Address - Phone:608-501-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health