Provider Demographics
NPI:1568214104
Name:LOCKE, LILY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:LOCKE
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 1:7441 CATHERINE ST
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2905
Mailing Address - Country:US
Mailing Address - Phone:423-435-3657
Mailing Address - Fax:
Practice Address - Street 1:7146 NOLENSVILLE RD
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9585
Practice Address - Country:US
Practice Address - Phone:615-283-6150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist