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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TRACIE PENDARVIS

Active Sole Proprietor

TRACIE PENDARVIS is a Developmental Therapist healthcare provider located in BOSSIER CITY, Louisiana. NPI 1215200191 is currently active in the NPPES registry. Verify at CMS.

Developmental Therapist · BOSSIER CITY, LA

Registration Details

NPI Number
1215200191
Provider Type
Individual
Gender
Female
NPI Issued
Feb 22, 2012 (14.502323965202 yrs)
Last Updated
Feb 22, 2012
Sole Proprietor
Yes

Practice Information

Address
5604 PAMPUS LN
BOSSIER CITY, LA, 711124951
Browse LA providers · Browse ZIP 71112
Phone
3184581834
Primary Specialty
Developmental Therapist
222Q00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.