Provider Demographics
NPI:1215782537
Name:NANNI, LYNDA (MS, SLP)
Entity type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:NANNI
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 CORNWALLIS DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3218
Mailing Address - Country:US
Mailing Address - Phone:609-405-1513
Mailing Address - Fax:
Practice Address - Street 1:721 CORNWALLIS DR
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-3218
Practice Address - Country:US
Practice Address - Phone:609-405-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-19
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00312200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist