Provider Demographics
NPI:1124861398
Name:STIMPSON, LYDIA LEIGH (MS, CF-SLP)
Entity type:Individual
Prefix:MISS
First Name:LYDIA
Middle Name:LEIGH
Last Name:STIMPSON
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11940 CAROLINA PLACE PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-7471
Mailing Address - Country:US
Mailing Address - Phone:704-541-9080
Mailing Address - Fax:
Practice Address - Street 1:11940 CAROLINA PLACE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-7471
Practice Address - Country:US
Practice Address - Phone:704-541-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30003077235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist