Individual
TRACY ANNE LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
1034 N 500 W, PROVO, UT 84604-3380
(801) 357-7475
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01122865
UT
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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