Tracy L Baxley Tullos, LCSW
NPI #1124120712 in Russellville, Arkansas
Provider Information
- NPI Number
- 1124120712
- Entity Type
- Individual
- Name
- Tracy L Baxley Tullos, LCSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- LCSW
- Enumeration Date
- Sep 2, 2006
- Last Updated
- May 5, 2015
Practice Location
- Address
- 3106 W 2ND CT
- Address 2
- SUITE 1
- City
- Russellville
- State
- Arkansas
- ZIP Code
- 72801-4503
- Phone
- (479) 880-5100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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