Healthcare Provider Details

I. General information

NPI: 1659032878
Provider Name (Legal Business Name): LAKIN DENA' GARAY CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAKIN DENA' WINTERS

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 7TH
SUNRAY TX
79086-1724
US

IV. Provider business mailing address

PO BOX 454
GOODWELL OK
73939-0454
US

V. Phone/Fax

Practice location:
  • Phone: 806-948-1188
  • Fax:
Mailing address:
  • Phone: 580-651-1997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number118358
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: