Provider Demographics
NPI:1760609150
Name:SABEL, TRACY L (SLP)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:L
Last Name:SABEL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:TRACY
Other - Middle Name:LYNNE
Other - Last Name:SABEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SLP
Mailing Address - Street 1:1213 GALAXY DR
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4402
Mailing Address - Country:US
Mailing Address - Phone:512-417-4726
Mailing Address - Fax:
Practice Address - Street 1:1213 GALAXY DR
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4402
Practice Address - Country:US
Practice Address - Phone:512-417-4726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0004744235Z00000X
TX19865235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150718801Medicaid