Individual
TRACY ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
2651 SOUTH AVE W, MISSOULA, MT 59804-6405
(406) 728-9162
Mailing address
210 S LAMRO ST, WINNER, SD 57580-1617
(605) 840-0631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-SP-LIC-9626
MT
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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