Provider Demographics
NPI:1255487427
Name:HUKILL, TRACY D (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:D
Last Name:HUKILL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 AMANDA CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-6267
Mailing Address - Country:US
Mailing Address - Phone:859-971-8135
Mailing Address - Fax:859-971-7152
Practice Address - Street 1:909 AMANDA CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-6267
Practice Address - Country:US
Practice Address - Phone:859-971-8135
Practice Address - Fax:859-971-7152
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2506235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist