| NPI | 1730627811 |
|---|---|
| Former Name | TRACI REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM 6278) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 15111) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2022-07-21 |