Provider Demographics
NPI:1730619370
Name:GILES, LAKAN (CF-SLP)
Entity type:Individual
Prefix:
First Name:LAKAN
Middle Name:
Last Name:GILES
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 CRITTENDEN MOUNT ZION RD
Mailing Address - Street 2:
Mailing Address - City:DRY RIDGE
Mailing Address - State:KY
Mailing Address - Zip Code:41035-8443
Mailing Address - Country:US
Mailing Address - Phone:606-899-4554
Mailing Address - Fax:
Practice Address - Street 1:9 WAVELAND AVE
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-1231
Practice Address - Country:US
Practice Address - Phone:855-584-5845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY173457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist