Individual
TRACY DEROLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
198 ABBEYWALK LN, COLUMBIA, SC 29229-8428
(585) 474-2796
Mailing address
198 ABBEYWALK LN, COLUMBIA, SC 29229-8428
(585) 474-2796
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5591
SC
Other
Enumeration date
09/22/2014
Last updated
09/22/2014
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