| Doctor Name: | LACEY J MCBRIDE |
| NPI Number: | 1891015855 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | 105034 |
| Business Practice Address: | 2522 E 70th St Shreveport, LA - 711054002 |
| Business Phone Number: | 3187953388 |
| Business Fax Number: | 3187953399 |
| Mailing Address: | 2522 E 70th St, SHREVEPORT |
| State: | LA |
| Postal Code: | 711054002 |
| Phone Number: | 3187953388 |
| Fax Number: | 3187953399 |
| NPI Enumeration Date: | 06/01/2010 |
| NPI Last Update Date: | 07/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 105034 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| 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 |