Individual
TRACEY A IRENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
1111 DELAFIELD ST, SUITE 102, WAUKESHA, WI 53188-3417
(262) 549-5150
(262) 549-1337
Mailing address
N67W23421 NANCY DR, SUSSEX, WI 53089-2786
(262) 820-0371
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
303-156
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41135900
—
WI
Enumeration date
02/01/2007
Last updated
04/04/2008
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