Individual
TRACY LYN TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 INDIANA AVE, MAYFIELD, KY 42066-1766
(270) 247-0200
Mailing address
150 GOLO RD, MAYFIELD, KY 42066-4853
(270) 705-6098
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3713
KY
Other
Enumeration date
11/26/2017
Last updated
11/26/2017
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