Lacey Paulett Anderson

Individual provider Active NPI Speech-Language Pathologist · Burleson, TX

NPI 1275019671 · NPPES record last updated May 28, 2019

Key facts

NPI
1275019671
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
112807 (TX)
Practice address
1101 Whispering Spring CT
Burleson, TX 76028
Phone
(817) 944-4710
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
112807TXMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 112807 TX Yes

Addresses

Primary practice location

1101 Whispering Spring CT
Burleson, TX 76028

Mailing address

1101 Whispering Spring CT
Burleson, TX 76028-1059
Phone (817) 944-4710

Other practice location 1

212 NW Lorna St Ste 103
Burleson, TX 76028-4110
Phone (817) 888-8454

Other providers in Burleson, TX

All providers in Burleson, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.