Provider Demographics
NPI:1033265988
Name:TRAFFORD, EDITH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:EDITH
Middle Name:
Last Name:TRAFFORD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15050 ELDERBERRY LN
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-8504
Mailing Address - Country:US
Mailing Address - Phone:508-269-0252
Mailing Address - Fax:
Practice Address - Street 1:15050 ELDERBERRY LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-8504
Practice Address - Country:US
Practice Address - Phone:508-269-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3665235Z00000X
RISP00518235Z00000X
FLSA13113235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist