Provider Demographics
NPI:1851546071
Name:KLEIN, TRACY GREENWOOD (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TRACY
Middle Name:GREENWOOD
Last Name:KLEIN
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 1:5131 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-6244
Mailing Address - Country:US
Mailing Address - Phone:216-402-9532
Mailing Address - Fax:
Practice Address - Street 1:5131 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80111-6244
Practice Address - Country:US
Practice Address - Phone:216-402-9532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0000177235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist