Provider Demographics
NPI:1306316963
Name:BERINGER, LYDIA PRICE (MS CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:PRICE
Last Name:BERINGER
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:MISS
Other - First Name:LYDIA
Other - Middle Name:PIERCE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC/SLP
Mailing Address - Street 1:3149 HATHAWAY PLACE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111
Mailing Address - Country:US
Mailing Address - Phone:334-538-6548
Mailing Address - Fax:
Practice Address - Street 1:300 S. TWINING STREET 42 ND MEDICAL GROUP
Practice Address - Street 2:
Practice Address - City:MAXWELL AFB
Practice Address - State:AL
Practice Address - Zip Code:36112
Practice Address - Country:US
Practice Address - Phone:334-953-4415
Practice Address - Fax:334-953-6646
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2388235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty