Provider Demographics
NPI:1073086286
Name:MANNARINO, LINDSEY E (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:E
Last Name:MANNARINO
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 1:8 COUNTRY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1571
Mailing Address - Country:US
Mailing Address - Phone:609-350-9115
Mailing Address - Fax:
Practice Address - Street 1:8 COUNTRY MEADOW DR
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1571
Practice Address - Country:US
Practice Address - Phone:609-350-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00722700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist