Provider Demographics
NPI:1043350259
Name:LAWRENCE, LINDSAY ELIZABETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ELIZABETH
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7320 N PALMYRA RD
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9709
Mailing Address - Country:US
Mailing Address - Phone:330-553-8755
Mailing Address - Fax:
Practice Address - Street 1:3403 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507-2044
Practice Address - Country:US
Practice Address - Phone:330-782-3003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7944235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000217945OtherANTHEM PROVIDER #
OH8674500Medicaid