Basic Information
| Provider Information | |||||||||
| NPI: | 1306373154 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SYKES | ||||||||
| FirstName: | LYSANDRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6548 WOODMERE DR | ||||||||
| Address2: | |||||||||
| City: | WALKERTOWN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 270519426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3369185119 | ||||||||
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| Practice Location | |||||||||
| Address1: | 518 N GENERALS BLVD | ||||||||
| Address2: | |||||||||
| City: | LINCOLNTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047480616 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/11/2017 | ||||||||
| LastUpdateDate: | 06/15/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 12397 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.