Individual
MS. TRACEY NICKOLE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 COUNTY ROAD 4860, AZLE, TX 76020-8850
(817) 585-0815
Mailing address
202 COUNTY ROAD 4860, AZLE, TX 76020-8850
(817) 585-0815
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
41963
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20842075
UMR
TX
Enumeration date
02/02/2022
Last updated
02/02/2022
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