Provider Demographics
NPI:1811238892
Name:OREGO, TRACY MWENDE (MA)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:MWENDE
Last Name:OREGO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 S PERIMETER ROAD SUITE 120
Mailing Address - Street 2:
Mailing Address - City:FORTLAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309
Mailing Address - Country:US
Mailing Address - Phone:954-958-3527
Mailing Address - Fax:954-958-3529
Practice Address - Street 1:1925 S PERIMETER RD STE 120
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-7123
Practice Address - Country:US
Practice Address - Phone:954-958-3527
Practice Address - Fax:954-958-3529
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor