Provider Demographics
NPI:1225873631
Name:HUMES-JAKES, TRACEY MICHELE
Entity type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:MICHELE
Last Name:HUMES-JAKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 SUMMIT DR APT 3209
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-2187
Mailing Address - Country:US
Mailing Address - Phone:617-230-4987
Mailing Address - Fax:
Practice Address - Street 1:3209 SUMMIT DR APT 3209
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02324-2187
Practice Address - Country:US
Practice Address - Phone:617-230-4987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor