Provider Information for 1043039472
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TRACY Y HABACIVCH LPC
Sex: Female
NPI: 1043039472
Last Updated: 2024-10-03
Certification Date: 2024-10-03
Certification Date: 2024-10-03
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1043039472 | ||||||||
| Enumeration Date | 2024-10-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2493 IMPALA DR RONKS, PA 17572-9626 United States Phone: 717-572-2331 | Fax: | ||||||||
| Primary Practice Address | 2493 IMPALA DR RONKS, PA 17572-9626 United States Phone: 717-572-2331 | Fax: | ||||||||
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