Individual
MS. TRACY L NANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-SP
Contact information
Practice address
1537 24TH AVE, LEWISTON, ID 83501-6379
(724) 331-4534
Mailing address
1537 24TH AVE, LEWISTON, ID 83501-6379
(724) 331-4534
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1165
HI
235Z00000X
Speech-Language Pathologist
Primary
2858
ID
235Z00000X
Speech-Language Pathologist
61096683
WA
Other
Enumeration date
11/22/2012
Last updated
12/23/2020
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