Provider Demographics
NPI:1053490243
Name:HARDEE, LYNNLY CUPSTID (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:LYNNLY
Middle Name:CUPSTID
Last Name:HARDEE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:LYNNLY
Other - Middle Name:
Other - Last Name:CUPSTID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 S JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510
Mailing Address - Country:US
Mailing Address - Phone:337-258-0339
Mailing Address - Fax:
Practice Address - Street 1:220 S JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-5906
Practice Address - Country:US
Practice Address - Phone:337-898-5816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4718235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist