Traci Lynn Blancke | Ann Arbor, MI • PECOS Search

Traci Lynn Blancke

Social Worker

Behavioral Health & Social Service Providers

401 N Division St, Ann Arbor, MI 48104-1442

PECOS Enrollment

Based on the most recent information from CMS, provider Traci Lynn Blancke does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1588971311
Provider Type
Individual
Full Name
Blancke, Traci Lynn
Credential
MSW, LMSW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/31/2010
Last Updated
3/29/2019

Contact Information

Practice Location

401 N Division St, Ann Arbor, MI 48104-1442

Unlisted Fax

Mailing Location

520 N Ashley St Apt 14, Ann Arbor, MI 48103-3366

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License Unlisted Issuer