Individual
JESSICA TRACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3160 N ARIZONA AVE STE 105, CHANDLER, AZ 85225-7122
(480) 365-9981
Mailing address
223 WOODYCREST DR, HOLTSVILLE, NY 11742-1714
(631) 560-8597
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP13148
AZ
Other
Enumeration date
07/06/2021
Last updated
07/06/2021
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