Provider Demographics
NPI:1114725603
Name:KYEI, TRACEY
Entity type:Individual
Prefix:MRS
First Name:TRACEY
Middle Name:
Last Name:KYEI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MEADOW CREEK DR STE 1.107
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-9426
Mailing Address - Country:US
Mailing Address - Phone:410-876-1200
Mailing Address - Fax:
Practice Address - Street 1:410 MEADOW CREEK DR STE 1.107
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21158-9426
Practice Address - Country:US
Practice Address - Phone:410-876-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01702231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist