Individual
TRACY JILL WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1513 GABALDON RD NW TRLR A12, ALBUQUERQUE, NM 87104-2763
(505) 401-5733
Mailing address
1513 GABALDON RD NW TRLR A12, ALBUQUERQUE, NM 87104-2763
(505) 401-5733
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1307
NM
235Z00000X
Speech-Language Pathologist
24495665
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24495665
COLORADO DEPARTMENT OF EDUCATION
CO
05
—
K 8266
—
NM
Enumeration date
03/08/2007
Last updated
01/17/2025
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