MEDICARE: MS. TRACY GEIST M.S.,C.C.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SL004744L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699892588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRACY GEIST M.S.,C.C.C.

Provider Business Mailing Address
First Line	:	954 WALNUT DR.
Second Line	:
City	:	PALMERTON
State	:	PA
Zip	:	18071-6569
Country	:	US
Telephone Number	:	610-377-9125
Fax Number	:

Provider Business Practice Location Address
First Line	:	146 NORTH ST
Second Line	:
City	:	LEHIGHTON
State	:	PA
Zip	:	18235-1546
Country	:	US
Telephone Number	:	610-393-7980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/09/2007

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Directions to “ MS. TRACY GEIST M.S.,C.C.C.” Practice Location

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