Provider Demographics
NPI:1528452216
Name:COWHERD, LYNNETTE (MS CCCSLP)
Entity type:Individual
Prefix:MRS
First Name:LYNNETTE
Middle Name:
Last Name:COWHERD
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24545 EE HWY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:MO
Mailing Address - Zip Code:64633-8144
Mailing Address - Country:US
Mailing Address - Phone:660-542-2631
Mailing Address - Fax:
Practice Address - Street 1:24545 EE HWY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:MO
Practice Address - Zip Code:64633-8144
Practice Address - Country:US
Practice Address - Phone:660-542-2631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO109227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist