Provider Demographics
NPI:1700211877
Name:FIELDS, LAKEISHA BROWN (SLP)
Entity Type:Individual
Prefix:
First Name:LAKEISHA
Middle Name:BROWN
Last Name:FIELDS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 S CEDAR RIDGE DR UNIT 471
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4526
Mailing Address - Country:US
Mailing Address - Phone:972-649-9903
Mailing Address - Fax:972-649-9903
Practice Address - Street 1:321 S CEDAR RIDGE DR UNIT 471
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4526
Practice Address - Country:US
Practice Address - Phone:972-649-9903
Practice Address - Fax:972-649-9903
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108116235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist