Doctor Name: | DR. KIMBERLY CAREN CRAWFORD LACKEY |
NPI Number: | 1659563625 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D., CCC-SLP |
License Number: | 7826 |
Business Practice Address: | 6102 Lighted Way Ln Indian Trail, NC - 280795606 |
Business Phone Number: | 8504456076 |
Business Fax Number: | |
Mailing Address: | 6102 Lighted Way Ln, INDIAN TRAIL |
State: | NC |
Postal Code: | 280795606 |
Phone Number: | 8504456076 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2007 |
NPI Last Update Date: | 06/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7826 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |