Provider Demographics
NPI:1184921900
Name:CLIFFORD, LUCY M (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LUCY
Middle Name:M
Last Name:CLIFFORD
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 1:2908 WINDMERE CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6527
Mailing Address - Country:US
Mailing Address - Phone:336-794-0608
Mailing Address - Fax:
Practice Address - Street 1:2908 WINDMERE CT
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-6527
Practice Address - Country:US
Practice Address - Phone:336-794-0608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4161235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist