Provider Demographics
NPI:1316317746
Name:TDD THERAPY SOLUTIONS, INC
Entity type:Organization
Organization Name:TDD THERAPY SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH/LANGUAGE PATHOLOGIST; OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:DUCEY
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC/SLP
Authorized Official - Phone:618-580-9071
Mailing Address - Street 1:3301 GREENBRIAR AVE
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-3236
Mailing Address - Country:US
Mailing Address - Phone:618-580-9071
Mailing Address - Fax:618-466-1015
Practice Address - Street 1:3301 GREENBRIAR AVE
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-3236
Practice Address - Country:US
Practice Address - Phone:618-580-9071
Practice Address - Fax:618-466-1015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty