Provider Demographics
NPI:1982643649
Name:SCHULTZ, TRACY DEBORAH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:DEBORAH
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8308
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37414-0308
Mailing Address - Country:US
Mailing Address - Phone:423-710-4354
Mailing Address - Fax:423-710-3865
Practice Address - Street 1:5441 TN-153
Practice Address - Street 2:STE 200
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343
Practice Address - Country:US
Practice Address - Phone:423-710-3864
Practice Address - Fax:423-710-3865
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN2912103TC0700X
TX33126103TC0700X
NY015384-01103TC0700X
TN2912103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical