Individual
MRS. TRACIE JENNIFER WIDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
2190 WINFIELD DUNN PKWY, SEVIERVILLE, TN 37876-0502
(865) 280-2799
(865) 366-2384
Mailing address
2190 WINFIELD DUNN PKWY, SEVIERVILLE, TN 37876-0502
(865) 280-2799
(865) 366-2384
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000003613
TN
Other
Enumeration date
07/09/2013
Last updated
04/19/2022
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