Healthcare Provider Details

I. General information

NPI: 1508781667
Provider Name (Legal Business Name): TRACY ARNOLD HENRY M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY ANN ARNOLD M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W 27TH AVE
COVINGTON LA
70433-1276
US

IV. Provider business mailing address

307 S PIERCE ST
COVINGTON LA
70433-1960
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-6204
  • Fax:
Mailing address:
  • Phone: 985-768-8940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5921
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: