Provider Demographics
NPI:1962869529
Name:VERCHOT, LUCINDA EILEEN KAAY (CCC/SLP)
Entity type:Individual
Prefix:
First Name:LUCINDA
Middle Name:EILEEN KAAY
Last Name:VERCHOT
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 NELSON ST SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-5232
Mailing Address - Country:US
Mailing Address - Phone:256-227-6558
Mailing Address - Fax:
Practice Address - Street 1:4320 JUDITH LN SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-3363
Practice Address - Country:US
Practice Address - Phone:256-837-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1511235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist