Traci Leigh Folsom

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA17251 Issued in FL

Practice address

9470 Corkscrew Palms Cir Ste 104
Estero, FL 33928-3305

Phone

(239) 400-1705

Fax

(239) 298-7673

NPI assigned

Aug 30, 2012

Last updated

Jun 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1003165572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9470 CORKSCREW PALMS CIR STE 104",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283305",
            "telephone_number": "239-400-1705",
            "fax_number": "239-298-7673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470 CORKSCREW PALMS CIR STE 104",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339283305",
            "telephone_number": "239-400-1705",
            "fax_number": "239-298-7673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "474 Tarrant Rd",
            "address_purpose": "LOCATION",
            "city": "Gardendale",
            "state": "AL",
            "postal_code": "350712947",
            "country_code": "US",
            "telephone_number": "205-608-2999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOLSOM",
        "first_name": "TRACI",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-30",
        "last_updated": "2022-06-07",
        "certification_date": "2022-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AL",
            "license": "2423",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Estero, FL
• Providers in Estero, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.