Individual
TRACY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
513 S. PATTERSON DR., MOORE, OK 73160
(580) 571-1214
Mailing address
513 S. PATTERSON DR., MOORE, OK 73160
(580) 571-1214
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3165
OK
Other
Enumeration date
12/20/2006
Last updated
02/16/2023
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