Provider Demographics
NPI:1235352261
Name:LYNCH, CASSIE D (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:D
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MS, 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:RR 2 BOX 121
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:IL
Mailing Address - Zip Code:62476-9632
Mailing Address - Country:US
Mailing Address - Phone:618-456-3512
Mailing Address - Fax:
Practice Address - Street 1:800 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-2553
Practice Address - Country:US
Practice Address - Phone:618-395-6099
Practice Address - Fax:618-395-6289
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist