Provider Demographics
NPI:1235455718
Name:ABPLANALP, TRACY ELIZABETH (MS/CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:ELIZABETH
Last Name:ABPLANALP
Suffix:
Gender:F
Credentials:MS/CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 DEWITT FLATS RD.
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12791-0286
Mailing Address - Country:US
Mailing Address - Phone:845-741-9382
Mailing Address - Fax:845-482-4005
Practice Address - Street 1:123 DEWITT FLATS RD.
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12791-0286
Practice Address - Country:US
Practice Address - Phone:845-741-9382
Practice Address - Fax:845-482-4005
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018706235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist