Provider Demographics
NPI:1003978305
Name:THAXTON-LANKFORD, DARLENE J (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:J
Last Name:THAXTON-LANKFORD
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 1:2840 DAVIS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-5917
Mailing Address - Country:US
Mailing Address - Phone:423-309-2192
Mailing Address - Fax:
Practice Address - Street 1:2840 DAVIS RIDGE RD
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-5917
Practice Address - Country:US
Practice Address - Phone:423-309-2192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004014235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist