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Individual

LACEY J MCBRIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
2522 E 70TH ST, SHREVEPORT, LA 71105-4002
(318) 795-3388
(318) 795-3399
Mailing address
2522 E 70TH ST, SHREVEPORT, LA 71105-4002
(318) 795-3388
(318) 795-3399

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
105034
TX
235Z00000X
Speech-Language Pathologist
Primary
6571
LA

Other

Enumeration date
06/01/2010
Last updated
07/11/2012
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