Individual
TRACIE WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
514 S BROWN ST, SPRINGFIELD, TN 37172-2937
(615) 382-0500
Mailing address
PO BOX 1637, SPRINGFIELD, TN 37172-1637
(615) 382-0500
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6978
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6978
STATE LICENSE
TN
Enumeration date
07/27/2020
Last updated
07/27/2020
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