Provider Demographics
NPI:1124725585
Name:DRISKELL, LYNDSEY KAY (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:KAY
Last Name:DRISKELL
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:PO BOX 342
Mailing Address - Street 2:
Mailing Address - City:GROVETON
Mailing Address - State:TX
Mailing Address - Zip Code:75845-0342
Mailing Address - Country:US
Mailing Address - Phone:936-243-6655
Mailing Address - Fax:
Practice Address - Street 1:112 S MAIN
Practice Address - Street 2:
Practice Address - City:GROVETON
Practice Address - State:TX
Practice Address - Zip Code:75845-0075
Practice Address - Country:US
Practice Address - Phone:936-243-6655
Practice Address - Fax:936-229-4851
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118081235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist