Provider Demographics
NPI:1104598093
Name:LOMBARDI, NATALIE LYNN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:LYNN
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11515 CRYSTAL POINTE DR UNIT 102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-7833
Mailing Address - Country:US
Mailing Address - Phone:317-504-3713
Mailing Address - Fax:
Practice Address - Street 1:1885 PORTER LAKE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-7893
Practice Address - Country:US
Practice Address - Phone:855-693-7822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13147235Z00000X
NC14302364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist