Doctor Name: | MRS. TRACIE C MOSS |
NPI Number: | 1023112372 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCCSLP |
License Number: | 3186 |
Business Practice Address: | 300 Stonecrest Blvd Ste 375 Smyrna, TN - 37167 |
Business Phone Number: | 6152205796 |
Business Fax Number: | 6152208829 |
Mailing Address: | 2887 A Nonaville Rd, MOUNT JULIET |
State: | TN |
Postal Code: | 37122 |
Phone Number: | 6153908188 |
Fax Number: | 6157549478 |
NPI Enumeration Date: | 09/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3186 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |