Provider Demographics
NPI:1184207128
Name:ROECKER, LYNDI
Entity Type:Individual
Prefix:
First Name:LYNDI
Middle Name:
Last Name:ROECKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 GREAT CIRCLE RD APT 315
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1673
Mailing Address - Country:US
Mailing Address - Phone:309-634-8994
Mailing Address - Fax:
Practice Address - Street 1:PROJECT PLAY THERAPY
Practice Address - Street 2:
Practice Address - City:7146 NOLENSVILLE RD
Practice Address - State:TN
Practice Address - Zip Code:37135
Practice Address - Country:US
Practice Address - Phone:615-283-6150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-28
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist