Perez, Tracy Alexander

Perez, Tracy Alexander is an individual health care provider with primary practice located at 3615 Braselton Hwy Suite 103, Dacula GA 30019-5907. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Perez, Tracy Alexander can be contacted via phone (678) 377-9634.

Contact Information

Primary practice address
3615 Braselton Hwy Suite 103 Dacula GA 30019-5907
Phone: (678) 377-9634
Fax: (678) 377-9609
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP003258 Georgia

Profile Details

NPI number 1366530818
LBN Legal business name Perez, Tracy Alexander
Credentials M.S., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366530818 NPPES
Georgia MEDICAID 305508
Georgia Other 52637149 002
Georgia MEDICAID 10041573

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