Provider Demographics
NPI:1578739363
Name:KLINKHAMER, LUCI H (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LUCI
Middle Name:H
Last Name:KLINKHAMER
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 1:430 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1217
Mailing Address - Country:US
Mailing Address - Phone:248-348-9693
Mailing Address - Fax:
Practice Address - Street 1:10400 HAMBURG RD
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:MI
Practice Address - Zip Code:48139-1204
Practice Address - Country:US
Practice Address - Phone:810-231-9042
Practice Address - Fax:810-231-9063
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist