Provider Demographics
NPI:1275687949
Name:JANSEN, LINDSIE PAIGE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSIE
Middle Name:PAIGE
Last Name:JANSEN
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 1:11 CONNELL DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-1507
Mailing Address - Country:US
Mailing Address - Phone:501-312-4190
Mailing Address - Fax:
Practice Address - Street 1:407 CARSON ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6852
Practice Address - Country:US
Practice Address - Phone:501-620-5525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist