Provider Demographics
NPI:1851535942
Name:CUMMINGS-LOCKLEAR, JANET GAIL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:GAIL
Last Name:CUMMINGS-LOCKLEAR
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:PO BOX 1418
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-1418
Mailing Address - Country:US
Mailing Address - Phone:910-522-0611
Mailing Address - Fax:
Practice Address - Street 1:4151 PROSPECT RD
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NC
Practice Address - Zip Code:28372-8400
Practice Address - Country:US
Practice Address - Phone:910-522-0611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist