Provider Demographics
NPI:1588901797
Name:NEARY, TRACI ANNE (MFT)
Entity type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:ANNE
Last Name:NEARY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CLARMONT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5705
Mailing Address - Country:US
Mailing Address - Phone:267-525-7001
Mailing Address - Fax:267-525-7011
Practice Address - Street 1:800 CLARMONT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5705
Practice Address - Country:US
Practice Address - Phone:267-525-7001
Practice Address - Fax:267-525-7011
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000710106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist