Individual
ANNA CATHERINE LACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1411 HIGHWAY 389, STARKVILLE, MS 39759
(662) 769-4888
(662) 338-5439
Mailing address
1411 HIGHWAY 389, STARKVILLE, MS 39759-8451
(662) 769-4888
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
7476
LA
235Z00000X
Speech-Language Pathologist
Primary
S4525
MS
Other
Enumeration date
01/18/2018
Last updated
02/06/2019
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