Provider Demographics
NPI:1134351018
Name:LUM LOCK, KERRIE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:KERRIE
Middle Name:
Last Name:LUM LOCK
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9490 JAMAICA DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1708
Mailing Address - Country:US
Mailing Address - Phone:305-256-4116
Mailing Address - Fax:305-256-4116
Practice Address - Street 1:9490 JAMAICA DR
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1708
Practice Address - Country:US
Practice Address - Phone:305-256-4116
Practice Address - Fax:305-256-4116
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-11
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst