Provider Demographics
NPI:1003181066
Name:OVERTON, LINDSAY BETH (MSLP)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:BETH
Last Name:OVERTON
Suffix:
Gender:F
Credentials:MSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 A AVE E
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-2816
Mailing Address - Country:US
Mailing Address - Phone:641-676-6759
Mailing Address - Fax:641-676-6758
Practice Address - Street 1:114 A AVE E
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-2816
Practice Address - Country:US
Practice Address - Phone:641-676-6759
Practice Address - Fax:641-676-6758
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB66133487235Z00000X
IA072311235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB3131001Medicare PIN