Provider Demographics
NPI:1871374504
Name:DR TRACEY AND HEALING CONNECTIONS PLLC
Entity type:Organization
Organization Name:DR TRACEY AND HEALING CONNECTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LASZLOFFY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-608-7941
Mailing Address - Street 1:4414 WORTHYLAKE RUN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-7084
Mailing Address - Country:US
Mailing Address - Phone:704-608-7941
Mailing Address - Fax:
Practice Address - Street 1:4414 WORTHYLAKE RUN
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-7084
Practice Address - Country:US
Practice Address - Phone:704-608-7941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty