Provider Demographics
NPI:1477733707
Name:VALE, TRACY JEANNE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:JEANNE
Last Name:VALE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 NEWHALL ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02721-4430
Mailing Address - Country:US
Mailing Address - Phone:774-526-9880
Mailing Address - Fax:
Practice Address - Street 1:250 NEWHALL ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02721-4430
Practice Address - Country:US
Practice Address - Phone:774-526-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-03
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3520235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist