Healthcare Provider Details
I. General information
NPI: 1992336028
Provider Name (Legal Business Name): KACEY LU SNEED
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/28/2020
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4300 LONG BEACH BLVD STE 700
LONG BEACH CA
90807-2000
US
IV. Provider business mailing address
744 ESTES PARK DR
SAINT PETERS MO
63376-2089
US
V. Phone/Fax
- Phone: 818-894-2273
- Fax: 818-357-2505
- Phone: 702-683-8885
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 2021043518 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 31453 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 15225 |
| License Number State | NC |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 035545 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: