Provider Demographics
NPI:1215094198
Name:CRANFORD, LAMESHEA DEAN (SPEECH THERAPIST)
Entity type:Individual
Prefix:
First Name:LAMESHEA
Middle Name:DEAN
Last Name:CRANFORD
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7616 COLE LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1094
Mailing Address - Country:US
Mailing Address - Phone:404-754-9506
Mailing Address - Fax:770-756-9607
Practice Address - Street 1:7616 COLE LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-1094
Practice Address - Country:US
Practice Address - Phone:404-754-9506
Practice Address - Fax:770-756-9607
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA601729356BMedicaid