Provider Demographics
NPI:1699337014
Name:LE, LACI KAY (AUD)
Entity type:Individual
Prefix:
First Name:LACI
Middle Name:KAY
Last Name:LE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7403 WURZBACH RD APT 408
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3843
Mailing Address - Country:US
Mailing Address - Phone:618-978-0630
Mailing Address - Fax:
Practice Address - Street 1:156 W SUNSET RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5760
Practice Address - Country:US
Practice Address - Phone:210-802-4058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-05
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81321231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist