Provider Demographics
NPI:1861647646
Name:DELIO, TRACEY MICHELLE (MA CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:TRACEY
Middle Name:MICHELLE
Last Name:DELIO
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 1:8 BARSTOW RD
Mailing Address - Street 2:7F
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3502
Mailing Address - Country:US
Mailing Address - Phone:516-829-3529
Mailing Address - Fax:
Practice Address - Street 1:8 BARSTOW RD
Practice Address - Street 2:7F
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3502
Practice Address - Country:US
Practice Address - Phone:516-829-3529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010431-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist