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General NPI Number Information
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NPI Number | 1558673335
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Entity Type | Individual
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Provider Name | TRACY M FRANK MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 509 W A ST
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City | DIXON
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State | CA
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Zip | 95620-3323
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Country | US
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Telephone | 707-294-3161
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3335
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City | FAIRFIELD
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State | CA
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Zip | 94533-0735
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Country | US
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Telephone | 707-294-3161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 12040854
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License Number State | CA
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