MRS. TRACI B FREDMAN (NPI# 1235387184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235387184 |
| Entity Type | Individual |
| Full Name | MRS. TRACI B FREDMAN |
| Credential | MS,CCC-SLP |
| Practice Address |
2501 4th Ave Canyon TX 79016-0001 |
| Mailing Address |
Wtamu Box 60757 Canyon TX 79016-0001 |
| Practice Telephone | 8066515101 |
| Practice Fax Number | 8066515105 |
| Mailing Telephone | 8066515101 |
| Mailing Fax Number | 8066515105 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2016-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | 101972 | TX | Speech, Language and Hearing Service Providers |
| Street Address |
2501 4TH AVE |
| City | CANYON |
| State | TX |
| Zip Code | 79016-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821469487 | Noel Francis Clifton | Speech-Language Pathologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2015-10-08 |
| 1669881017 | Jeffrey Case | Specialist/Technologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2014-08-11 |
| 1043571938 | Leslie W Dalton Jr. | Audiologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2012-06-06 |
| 1194083311 | West Texas A & M University | Clinic/Center | 2501 4th Ave, Canyon, TX 79016-0001 | 2012-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912920844 | Candy C Marshall | Nurse Practitioner | 2620 Russell Long Blvd, Canyon, TX 79016 | 2006-07-25 |
| 1811400666 | Tracey Dianne Ecklund | Student in an Organized Health Care Education/Training Program | 2620 Russel Long Blvd, Canyon, TX 79016-0001 | 2017-11-14 |
| 1689014326 | Lorna Strong | Specialist/Technologist | 2342 Russell Long Blvd, Virgil Henson Activities Center 217, Canyon, TX 79016-0001 | 2013-06-26 |
| 1790971224 | Sally Lynn Gaines | Student in an Organized Health Care Education/Training Program | West Texas A & M University, Old Main, Room 308-a, Canyon, TX 79016-0001 | 2007-09-19 |
| 1639394984 | Robby Douglas Rhodes | Specialist/Technologist | 60216 Wtamu, Canyon, TX 79016-0001 | 2007-04-13 |
| 1992869929 | James Edward Gibbs | Family Medicine | Student Medical Services, 2620 Russell Long Blvd., Canyon, TX 79016-0001 | 2006-12-21 |
| 1407967599 | West Texas A&m University Student Medical Services | Clinic/Center | 2620 N Russel Long Blvd, Virgil Henson Activities Center Room 104, Canyon, TX 79016-0001 | 2006-08-31 |
| 1245341692 | Wendy L Bertram | Nurse Practitioner | 2620 N. Russell Long Blvd, Canyon, TX 79016-0001 | 2006-08-31 |
| 1376526129 | Karen Elizabeth Knapp | Nurse Practitioner | Wt Box 61401, Canyon, TX 79016-0001 | 2005-11-25 |
| 1912410762 | Heather Ann Ferrell | Specialist/Technologist | 2620 Russel Long Blvd, Canyon, TX 79016-0001 | 2017-11-14 |
| Find all providers in zip 79016 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689023434 | Jessica Carpenter | Speech-Language Pathologist | 1215 Hillcrest Dr, Canyon, TX 79015-5219 | 2016-06-11 |
| 1821469487 | Noel Francis Clifton | Speech-Language Pathologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2015-10-08 |
| 1013240340 | Ann S Wallace | Speech-Language Pathologist | 2620 Russell Long Blvd, Vhac 242, Dept. of Comm. Dis., Canyon, TX 79016-0001 | 2009-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083430 | Laura Gallups | Speech-Language Pathologist | 25 Leonard Trl, Westworth Village, TX 76114-4037 | 2020-11-07 |
| 1215538509 | Laura Langford Smith | Speech-Language Pathologist | 7309 Janna Dr, Abilene, TX 79606-5323 | 2020-11-04 |
| 1629679725 | Haley Brawner Warren | Speech-Language Pathologist | 5800 Broadway Ste 106, San Antonio, TX 78209-5257 | 2020-11-04 |
| 1639770142 | Kaitlyn Hazlewood | Speech-Language Pathologist | 7204 Ellis Rd, Fort Worth, TX 76112-4302 | 2020-11-03 |
| 1538760137 | Stefani Stovall | Speech-Language Pathologist | 203 Bo Gibbs Blvd, Glen Rose, TX 76043 | 2020-11-02 |
| 1285234971 | Hilary Rodriguez Febus | Speech-Language Pathologist | 1 Hermann Park Ct Apt 111, Houston, TX 77021-2273 | 2020-10-30 |
| 1023617511 | Samantha Lynne Weston | Speech-Language Pathologist | 8515 Brodie Lane, Apt 2011, Austin, TX 78745 | 2020-10-26 |
| 1477153815 | Into Words Therapy Pllc | Speech-Language Pathologist | 11501 Oak Knoll Dr, Austin, TX 78759-3802 | 2020-10-26 |
| 1174122618 | Thoughtful Slp, Pllc | Speech-Language Pathologist | 7806 Copperas Dr, Austin, TX 78749-3807 | 2020-10-24 |
| 1194324723 | Ashley Panakezham | Speech-Language Pathologist | 800 Bonaventure Way Ste 147, Sugar Land, TX 77479-8006 | 2020-10-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.