Doctor Name: | MS. TRACIE NICOLE ADAMS |
NPI Number: | 1275804148 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | KY 2985 |
Business Practice Address: | 2384 Placid Dr Fort Walton Beach, FL - 325472579 |
Business Phone Number: | 8504994227 |
Business Fax Number: | |
Mailing Address: | 2384 Placid Dr, FORT WALTON BEACH |
State: | FL |
Postal Code: | 325472579 |
Phone Number: | 8504994227 |
Fax Number: | |
NPI Enumeration Date: | 01/24/2012 |
NPI Last Update Date: | 01/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | KY 2985 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
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 |