Doctor Name: | MS. TRACY LEE TUCKER |
NPI Number: | 1548316235 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 3120 |
Business Practice Address: | 300 N Kentucky Ave Roswell, NM - 882014636 |
Business Phone Number: | 5056374923 |
Business Fax Number: | 5056272544 |
Mailing Address: | 1201 N Lea Ave, ROSWELL |
State: | NM |
Postal Code: | 882015034 |
Phone Number: | 5056374923 |
Fax Number: | 5056272544 |
NPI Enumeration Date: | 01/26/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3120 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
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 |