Provider Demographics
NPI:1093811507
Name:STEVENS, LYNNE WASHINGTON (ME, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:WASHINGTON
Last Name:STEVENS
Suffix:
Gender:F
Credentials:ME, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 COLESVILLE MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-1144
Mailing Address - Country:US
Mailing Address - Phone:301-388-2211
Mailing Address - Fax:301-388-2452
Practice Address - Street 1:315 COLESVILLE MANOR DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1144
Practice Address - Country:US
Practice Address - Phone:301-388-2211
Practice Address - Fax:301-388-2452
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02546235Z00000X
VA2202002141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDYC17LWOtherCAREFIRST BC/BS