Provider Demographics
NPI:1174774525
Name:KERNS-LOCKLEAR, SCHNELE RENEE (MED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SCHNELE
Middle Name:RENEE
Last Name:KERNS-LOCKLEAR
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 ALFORDSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-8969
Mailing Address - Country:US
Mailing Address - Phone:910-521-8410
Mailing Address - Fax:
Practice Address - Street 1:885 ALFORDSVILLE RD
Practice Address - Street 2:
Practice Address - City:ROWLAND
Practice Address - State:NC
Practice Address - Zip Code:28383-8969
Practice Address - Country:US
Practice Address - Phone:910-521-8410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5754235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412300Medicaid