Individual
LEEANNA LANCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
564 RIDGE AVE, LIBERTY, NC 27298-3604
(336) 703-8872
Mailing address
564 RIDGE AVE, LIBERTY, NC 27298-3604
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12515
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12515
SPEECH LANGUAGE PATHOLOGY
NC
Enumeration date
11/06/2017
Last updated
11/06/2017
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