Provider Demographics
NPI:1659581304
Name:MCGUIRE, TRACI KEMPF (MS-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:KEMPF
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11179 TRUMPETER CT
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:KY
Mailing Address - Zip Code:41094-8383
Mailing Address - Country:US
Mailing Address - Phone:859-992-4540
Mailing Address - Fax:877-820-3121
Practice Address - Street 1:11179 TRUMPETER CT
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:KY
Practice Address - Zip Code:41094-8383
Practice Address - Country:US
Practice Address - Phone:859-992-4540
Practice Address - Fax:877-820-3121
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist