Provider Demographics
NPI:1427332717
Name:COPELAND, TRACY (MS,MED/CCC-SLP)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:COPELAND
Suffix:
Gender:F
Credentials:MS,MED/CCC-SLP
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, MED/CCC-SLP
Mailing Address - Street 1:4 OFFICE PARK CIR STE 314-A
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2697
Mailing Address - Country:US
Mailing Address - Phone:205-332-0112
Mailing Address - Fax:
Practice Address - Street 1:4 OFFICE PARK CIR STE 314-A
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2697
Practice Address - Country:US
Practice Address - Phone:205-332-0112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3097235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist