Provider Demographics
NPI:1801626890
Name:MCLAMB, KASI ANNE
Entity type:Individual
Prefix:
First Name:KASI
Middle Name:ANNE
Last Name:MCLAMB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 GOOD CIR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-5946
Mailing Address - Country:US
Mailing Address - Phone:910-403-0439
Mailing Address - Fax:
Practice Address - Street 1:34 GOOD CIR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-5946
Practice Address - Country:US
Practice Address - Phone:910-403-0439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician