Provider Demographics
NPI:1487125621
Name:TRAUMA AND RECOVERY SOLUTIONS, INC.
Entity type:Organization
Organization Name:TRAUMA AND RECOVERY SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:TACQUARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:951-764-0537
Mailing Address - Street 1:1504 PEBBLE BAY CT
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-1238
Mailing Address - Country:US
Mailing Address - Phone:951-764-0537
Mailing Address - Fax:951-848-9416
Practice Address - Street 1:1504 PEBBLE BAY CT
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1238
Practice Address - Country:US
Practice Address - Phone:951-764-0537
Practice Address - Fax:951-848-9416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203320OtherLICENSED MARRIAGE FAMILY THERAPIST
CA38834OtherLICENSED MARRIAGE AND FAMILY THERAPIST