Individual
TRACEY LEE GANGLUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,CCC,SLP
Contact information
Practice address
51738 SAGECREST DR, GRANGER, IN 46530-6887
(574) 339-5959
Mailing address
51738 SAGECREST DR, GRANGER, IN 46530-6887
(574) 339-5959
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01101056
IN
Other
Enumeration date
01/15/2010
Last updated
04/22/2010
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