Provider Demographics
NPI:1528898236
Name:KLEIN, TRACY LYNN (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:LYNN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N 4TH ST STE 22
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-3701
Mailing Address - Country:US
Mailing Address - Phone:928-821-1527
Mailing Address - Fax:
Practice Address - Street 1:2501 N 4TH ST STE 22
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3701
Practice Address - Country:US
Practice Address - Phone:928-821-1527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA7005231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist