Provider Demographics
NPI:1396821906
Name:GALLOWAY, TRACY F (MA)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:F
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:FAYE
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:46 E MADISON AVE APT 26
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2544
Mailing Address - Country:US
Mailing Address - Phone:859-236-0903
Mailing Address - Fax:
Practice Address - Street 1:120 DANIEL DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2527
Practice Address - Country:US
Practice Address - Phone:859-236-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0408231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist