Doctor Name: | MRS. TRACY K BARDING |
NPI Number: | 1699934695 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP/L |
License Number: | 146.005993 |
Business Practice Address: | 2715 N 27th St Decatur, IL - 625262126 |
Business Phone Number: | 2174291052 |
Business Fax Number: | |
Mailing Address: | 1410 W Mound Rd, DECATUR |
State: | IL |
Postal Code: | 625261273 |
Phone Number: | 2178777220 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2008 |
NPI Last Update Date: | 06/04/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 146.005993 |
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 |