Doctor Name: | MS. TRACIE LARA SODER |
NPI Number: | 1205161049 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A |
License Number: | SP13253 |
Business Practice Address: | 19040 Cox Ave Ste 5 Saratoga, CA - 950706601 |
Business Phone Number: | 4089962357 |
Business Fax Number: | |
Mailing Address: | 19040 Cox Ave Ste 5, SARATOGA |
State: | CA |
Postal Code: | 950706601 |
Phone Number: | 4089962357 |
Fax Number: | |
NPI Enumeration Date: | 10/13/2009 |
NPI Last Update Date: | 10/13/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP13253 |
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 |