Provider Demographics
NPI:1528443850
Name:HAWK, LINDSAY (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:HAWK
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:RR 2 BOX 172
Mailing Address - Street 2:APT #6
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-9780
Mailing Address - Country:US
Mailing Address - Phone:304-703-4080
Mailing Address - Fax:
Practice Address - Street 1:3900 TEAYS VALLEY ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526
Practice Address - Country:US
Practice Address - Phone:304-634-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-1606235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist