Doctor Name: | MS. TRACY RENE LOVEL |
NPI Number: | 1235231119 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC SLPL |
License Number: | |
Business Practice Address: | 602 W Woodlawn Avenue Jerseyville, IL - 620521065 |
Business Phone Number: | 6184984828 |
Business Fax Number: | |
Mailing Address: | 602 W Woodlawn Avenue, JERSEYVILLE |
State: | IL |
Postal Code: | 620521065 |
Phone Number: | 6184984828 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
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 |