Individual
TRACIE RHODEN BRAZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-CCC-SLP
Contact information
Practice address
43 AVIARY LN, JOHNSTON, SC 29832-2658
(803) 275-3767
Mailing address
43 AVIARY LN, JOHNSTON, SC 29832-2658
(803) 275-3767
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3298
SC
235Z00000X
Speech-Language Pathologist
SLP005513
GA
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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