Provider Demographics
NPI:1083914147
Name:CASH, TRACY BRENT (AUD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:BRENT
Last Name:CASH
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:DR
Other - First Name:TRACE
Other - Middle Name:BRENT
Other - Last Name:CASH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:4300 ROGERS AVE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3143
Mailing Address - Country:US
Mailing Address - Phone:479-785-3277
Mailing Address - Fax:479-785-3278
Practice Address - Street 1:4300 ROGERS AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3143
Practice Address - Country:US
Practice Address - Phone:479-785-3277
Practice Address - Fax:479-785-3278
Is Sole Proprietor?:No
Enumeration Date:2010-10-23
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR332231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist