Individual
MRS. LACEY MANGUM-JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
10712 BALUSTRADE CT, ZEBULON, NC 27597-6946
(602) 363-1863
Mailing address
10712 BALUSTRADE CT, ZEBULON, NC 27597-6946
(602) 363-1863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
11596
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PE-3X71K8DY6
—
NC
Enumeration date
07/27/2008
Last updated
01/27/2025
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