Tracy Gibson, D.I.
Individual provider Active NPI Developmental Therapist · West Paducah, KY
NPI 1194930867 · NPPES record last updated Jun 20, 2016
Key facts
- NPI
- 1194930867
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 3345 Tori Trail LN
West Paducah, KY 42086-9859 - Phone
- (270) 562-2065
- Fax
- (270) 534-5036
- NPI assigned
- May 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
3345 Tori Trail LN
West Paducah, KY 42086-9859
Mailing address
3345 Tori Trail LN
West Paducah, KY 42086-9859
Phone (270) 562-2065
Other providers in West Paducah, KY
- Amy Majors Cavitt
- Clare Blake Clark
- Ginger Tapp Devine
- Noah Heine
- Kayla Klope
- Johnnie Leon Knight
- Joe D. Littleton
- Mansfield Eye Clinic PLLC
All providers in West Paducah, KY · Developmental Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.