Provider Demographics
NPI:1134496813
Name:CITRANO, TRACEY MURPHY
Entity Type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:MURPHY
Last Name:CITRANO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TRACEY
Other - Middle Name:ELIZABETH
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4938 BERRYHILL CIR
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128-9109
Mailing Address - Country:US
Mailing Address - Phone:410-458-6893
Mailing Address - Fax:
Practice Address - Street 1:7700 YORK RD
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7513
Practice Address - Country:US
Practice Address - Phone:410-821-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist