Provider Demographics
NPI:1952912057
Name:LACOUR KELM, TARYN (SLP-CFY)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:LACOUR KELM
Suffix:
Gender:F
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16110 CONSTITUTION LN
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-3171
Mailing Address - Country:US
Mailing Address - Phone:409-651-6272
Mailing Address - Fax:
Practice Address - Street 1:16110 CONSTITUTION LN
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-3171
Practice Address - Country:US
Practice Address - Phone:409-651-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-12
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist