Provider Demographics
NPI:1144630203
Name:TRACI R GARRINGER, INC
Entity type:Organization
Organization Name:TRACI R GARRINGER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:870-425-2030
Mailing Address - Street 1:15 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3809
Mailing Address - Country:US
Mailing Address - Phone:870-425-2030
Mailing Address - Fax:870-425-7030
Practice Address - Street 1:15 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3809
Practice Address - Country:US
Practice Address - Phone:870-425-2030
Practice Address - Fax:870-425-7030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4033-C251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management