Provider Demographics
NPI:1124498035
Name:MICHAEL, LINDSEY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:MICHAEL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 17TH AVE N
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:64034-9802
Mailing Address - Country:US
Mailing Address - Phone:417-459-9308
Mailing Address - Fax:
Practice Address - Street 1:700 17TH AVE N
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MO
Practice Address - Zip Code:64034-9802
Practice Address - Country:US
Practice Address - Phone:417-459-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015014075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist