Individual
MRS. DONNA KAY LOCKE TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
114 GROVE PARK LOOP, WETUMPKA, AL 36093-3746
(334) 514-4970
Mailing address
114 GROVE PARK LOOP, WETUMPKA, AL 36093
(334) 514-4970
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1902
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12056945
ASHA
AL
01
—
1902
ABESPA LICENSE
AL
Enumeration date
01/14/2008
Last updated
01/14/2008
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