Doctor Name: | MS. NELDA C BRACK |
NPI Number: | 1306108550 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.-CCC-SLP |
License Number: | 2620 |
Business Practice Address: | 304 Griffin Gate Dr Apt B-10 Hopkinsville, KY - 422408763 |
Business Phone Number: | 2707052126 |
Business Fax Number: | |
Mailing Address: | 304 Griffin Gate Dr, Apt B-10 HOPKINSVILLE |
State: | KY |
Postal Code: | 422408763 |
Phone Number: | 2707052126 |
Fax Number: | |
NPI Enumeration Date: | 06/13/2012 |
NPI Last Update Date: | 06/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2620 |
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 |