Most Relevant Information
Provider Data
| NPI Number: | 1003372012 |
| Provider Name: | TRACY SPITZACK SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | 9902 |
Most Important Dates
| Enumeration Date: | 02/14/2019 |
| Last Updated: | 02/14/2019 |
Provider Practice Location
12450 CLOUD DR NE
BLAINE
MN
554496274
Practice Location Phone/Fax
| Phone: | 7637777117 |
| Fax: | 6514010598 |
Provider Mailing Location
12450 CLOUD DR NE
BLAINE
MN
554496274
Provider Mailing Phone/Fax
| Phone: | 7637777117 |
| Fax: | 6514010598 |