| Doctor Name: | MS. TRACY D. CARROLL |
| NPI Number: | 1003973686 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA CCC SLP |
| License Number: | SP 8121 |
| Business Practice Address: | 5100 N 6th St Suite 115a Fresno, CA - 937107514 |
| Business Phone Number: | 5599780701 |
| Business Fax Number: | 5593240541 |
| Mailing Address: | 1875 E Portland Ave, FRESNO |
| State: | CA |
| Postal Code: | 937202335 |
| Phone Number: | 5599780701 |
| Fax Number: | 5593240541 |
| NPI Enumeration Date: | 01/02/2007 |
| NPI Last Update Date: | 01/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP 8121 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |