Doctor Name: | TRACI D REID |
NPI Number: | 1013357649 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC,SLP |
License Number: | SLP008211 |
Business Practice Address: | 360 Charlyne Way Dacula, GA - 300192381 |
Business Phone Number: | 2522586200 |
Business Fax Number: | |
Mailing Address: | 360 Charlyne Way, DACULA |
State: | GA |
Postal Code: | 300192381 |
Phone Number: | 2522586200 |
Fax Number: | |
NPI Enumeration Date: | 06/27/2013 |
NPI Last Update Date: | 06/27/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP008211 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |