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General NPI Number Information
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NPI Number | 1952036287
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Entity Type | Individual
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Provider Name | SHEA LOCKAMY
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Gender | Female
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 14055 TOWN LOOP BLVD STE 300
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City | ORLANDO
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State | FL
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Zip | 32837-6106
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Country | US
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Telephone | 628-540-7857
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Fax |
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Provider Business Mailing Address
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Address Line | 101 NARANJA RD
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City | DEBARY
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State | FL
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Zip | 32713-3423
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Country | US
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Telephone | 407-414-0516
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA14987
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License Number State | FL
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