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Contact Information

TRACY HUMPHREY, CIT
400 LAKE FRONT DR
RUSSELLVILLE, AR72802-2206
 Phone: 479-968-7086
 Fax: 479-968-4331
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for TRACY HUMPHREY · (Female)

NPI Number 1750762969
Status Active
Credentials CIT
Entity Individual
Enumeration date 06/12/2015
Last updated 06/12/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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