Provider Demographics
NPI:1932542875
Name:KAUFMAN, TRACI LEE (MED)
Entity type:Individual
Prefix:
First Name:TRACI
Middle Name:LEE
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 SENECA ST FL 3
Mailing Address - Street 2:
Mailing Address - City:OIL CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16301-1371
Mailing Address - Country:US
Mailing Address - Phone:814-676-8627
Mailing Address - Fax:
Practice Address - Street 1:248 SENECA ST FL 3
Practice Address - Street 2:
Practice Address - City:OIL CITY
Practice Address - State:PA
Practice Address - Zip Code:16301-1371
Practice Address - Country:US
Practice Address - Phone:814-676-8627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health