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NPI Code Detail

MEDICARE: MRS. TRACY WREN PERKEY MCD,CCC-SLP

MEDICARE: MRS. TRACY WREN PERKEY MCD,CCC-SLP
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1780849927
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TRACY WREN PERKEY MCD,CCC-SLP
Provider Business Mailing Address
First Line : 2804 CARRIAGE HILL DR
Second Line :
City : PARAGOULD
State : AR
Zip : 72450-8361
Country : US
Telephone Number : 870-897-0208
Fax Number :
Provider Business Practice Location Address
First Line : 1606 PINE GROVE LN
Second Line :
City : HARRISBURG
State : AR
Zip : 72432-9304
Country : US
Telephone Number : 870-578-5426
Fax Number : 870-578-6005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2008
Last Update Date : 07/28/2008

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Directions to “ MRS. TRACY WREN PERKEY MCD,CCC-SLP” Practice Location

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