Provider Demographics
NPI:1407601552
Name:LITTLE, TRACY SKERIK
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:SKERIK
Last Name:LITTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 S NEWPORT CT # 80111
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4661
Mailing Address - Country:US
Mailing Address - Phone:303-915-2121
Mailing Address - Fax:
Practice Address - Street 1:CHERRY CREEK SCHOOL DISTRICT
Practice Address - Street 2:4750 S. YOSEMITE ST.
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1308
Practice Address - Country:US
Practice Address - Phone:303-915-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0005159235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist