Provider Demographics
NPI:1932842622
Name:SATTLER, TRACEY JO (BA, BHT)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:JO
Last Name:SATTLER
Suffix:
Gender:F
Credentials:BA, BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 E ENROSE ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-5933
Mailing Address - Country:US
Mailing Address - Phone:520-338-1840
Mailing Address - Fax:
Practice Address - Street 1:2111 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1516
Practice Address - Country:US
Practice Address - Phone:520-338-1840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician