Provider Demographics
NPI:1043757073
Name:WEBSTER, LYNDSEY (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:
Other - Last Name:WALDBURGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 HILLARY CIR APT D
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53038-9308
Mailing Address - Country:US
Mailing Address - Phone:715-853-9729
Mailing Address - Fax:
Practice Address - Street 1:435 HILLARY CIR APT D
Practice Address - Street 2:
Practice Address - City:JOHNSON CREEK
Practice Address - State:WI
Practice Address - Zip Code:53038-9308
Practice Address - Country:US
Practice Address - Phone:715-853-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-29
Last Update Date:2017-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4395-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist