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Individual

TRACI L LYNCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-MSSLP

Contact information

Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100
Mailing address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 533-9100

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00706
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2092
EI NHPRC
RI
01
292177
EI BLUE CROSS
RI
01
409287
BLUE CHIP
RI
01
412296
EI BCHIP
RI
01
4600103
EI UHP
RI
Enumeration date
09/27/2006
Last updated
07/08/2007
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