Provider Demographics
NPI:1003112129
Name:RAJAGOPAL, LAKSHMI (MS- CCC - SLP)
Entity Type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:
Last Name:RAJAGOPAL
Suffix:
Gender:F
Credentials:MS- CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 ARAF AVE
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5188
Mailing Address - Country:US
Mailing Address - Phone:972-644-7031
Mailing Address - Fax:
Practice Address - Street 1:916 ARAF AVE
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5188
Practice Address - Country:US
Practice Address - Phone:972-644-7031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18657235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist