Wise, Tracey Jane

Wise, Tracey Jane is an individual health care provider with primary practice located at 702 E King Rd , Tomahawk WI 54487. 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. Wise, Tracey Jane can be contacted via phone (715) 282-7566.

Contact Information

Primary practice address
702 E King Rd Tomahawk WI 54487
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 503-154 Wisconsin

Profile Details

NPI number 1912170564
LBN Legal business name Wise, Tracey Jane
Credentials MS CCC
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2008
Last updated Apr 3rd, 2008 - about 18 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 1912170564 NPPES
Wisconsin MEDICAID 426259000

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