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Individual
TRACY ANNE MARCINIAK
Active
Individual
TRACY ANNE MARCINIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
001872
IA
235Z00000X
Speech-Language Pathologist
Primary
2010007402
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665463
—
IA
Enumeration date
06/17/2009
Last updated
12/12/2013
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