Doctor Name: | TRACY LEE |
NPI Number: | 1881948297 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP/ATP |
License Number: | 41YS00362700 |
Business Practice Address: | 220 S Orange Ave Suite 300 Livingston, NJ - 070395804 |
Business Phone Number: | 9737639900 |
Business Fax Number: | 9737639905 |
Mailing Address: | 220 S Orange Ave, Suite 300 LIVINGSTON |
State: | NJ |
Postal Code: | 070395804 |
Phone Number: | 9737639900 |
Fax Number: | 9737639905 |
NPI Enumeration Date: | 11/07/2012 |
NPI Last Update Date: | 11/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 41YS00362700 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
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 |