Provider Demographics
NPI:1730313842
Name:VEGVARI, TRACEY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:VEGVARI
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 1:193 ROUTE 9 SOUTH
Mailing Address - Street 2:SUITE 2D LITTLE STEPS, INC.
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:732-683-1030
Mailing Address - Fax:732-683-0030
Practice Address - Street 1:193 ROUTE 9 SOUTH
Practice Address - Street 2:SUITE 2D LITTLE STEPS, INC.
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726
Practice Address - Country:US
Practice Address - Phone:732-683-1030
Practice Address - Fax:732-683-0030
Is Sole Proprietor?:No
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00592100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist