Doctor Name: | MRS. TRACEY ANNE BUFFUM |
NPI Number: | 1275733479 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED |
License Number: | SP00941 |
Business Practice Address: | 140 Point Judith Rd Unit 44, J. Trudeau Memorial Center Narragansett, RI - 028823451 |
Business Phone Number: | 4017836853 |
Business Fax Number: | |
Mailing Address: | 20 Greenbriar Pl, KINGSTON |
State: | RI |
Postal Code: | 028811733 |
Phone Number: | 4012843680 |
Fax Number: | |
NPI Enumeration Date: | 07/25/2007 |
NPI Last Update Date: | 07/25/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP00941 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | RI |
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 |