Individual
MS. LACEY JEAN CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
213 GLENDALE RD, NEWBERN, TN 38059
(303) 720-9160
Mailing address
213 GLENDALE RD, NEWBERN, TN 38059-5118
(303) 720-9160
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000004527
TN
235Z00000X
Speech-Language Pathologist
4150
KY
235Z00000X
Speech-Language Pathologist
ASHA12157421
—
235Z00000X
Speech-Language Pathologist
LL60326759
WA
235Z00000X
Speech-Language Pathologist
SLP0001902
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417389743
—
CO
Enumeration date
08/09/2013
Last updated
07/20/2023
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