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1255869434
TRACY DIANE BLACK
ELIZABETHTOWN, KY
NPI
1255869434
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: KY 173256)
Enumeration Date
2017-06-01
Last Update Date
2022-07-21
Business Address
TRACY DIANE BLACK M.S. CF-SLP
1609 N DIXIE AVE STE 114
ELIZABETHTOWN, KY 42701-7494
Phone number: 270-827-4652
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Mailing Address
TRACY DIANE BLACK M.S. CF-SLP
PO BOX 51322
BOWLING GREEN, KY 42102-5622
Phone number: 270-777-9283
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