Provider Demographics
NPI:1306256730
Name:MUIR, LYNETTE
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:MUIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 EAST 12300 SOUTH
Mailing Address - Street 2:SUITE #E2
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020
Mailing Address - Country:US
Mailing Address - Phone:801-485-5595
Mailing Address - Fax:801-467-1125
Practice Address - Street 1:392 E 12300 S
Practice Address - Street 2:SUITE #E2
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8181
Practice Address - Country:US
Practice Address - Phone:801-485-5595
Practice Address - Fax:801-467-1125
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT111220-4602237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist