Tracy Hennage, SLP
Speech-Language Pathologist, in Jonesborough, TN. Individual provider (NPI-1).
NPI number1396304366
StatusActive
Last updated in NPPESJun 12, 2019
Details
- NPI
- 1396304366
- Entity type
- Individual (NPI-1)
- Name
- Tracy Hennage
- Credential
- SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 12, 2019
- Last updated
- Jun 12, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - QUALIFIED SPEECH LANGUAGE PATHOLOGIST
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 5623 | TN | Yes |
Practice location
120 Newman RdJonesborough, TN 37659-6531
Phone 423-788-4468
Mailing address
120 Newman RdJonesborough, TN 37659-6531
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