Provider Demographics
NPI:1952348005
Name:HARWARD, TRACY CHRISTOPULOS (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:CHRISTOPULOS
Last Name:HARWARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MRS
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:CHRISTOPULOS HARWARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:12613 S FORT ST
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9382
Mailing Address - Country:US
Mailing Address - Phone:801-671-6225
Mailing Address - Fax:
Practice Address - Street 1:782 PIONEER RD
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020
Practice Address - Country:US
Practice Address - Phone:801-413-7471
Practice Address - Fax:801-566-2639
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT49329473902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist