Individual
TRACY W. POURCIAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
7341 CAPISTRANO DR, SHREVEPORT, LA 71105-5011
(318) 218-7384
Mailing address
7341 CAPISTRANO DR, SHREVEPORT, LA 71105-5011
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4869
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1302309
—
LA
Enumeration date
08/01/2007
Last updated
08/01/2007
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