Provider Demographics
NPI:1275887952
Name:SWEENEY, LYNN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:SWEENEY
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 1:2020 S MISSION ST
Mailing Address - Street 2:PMB 234
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-4425
Mailing Address - Country:US
Mailing Address - Phone:989-775-8082
Mailing Address - Fax:
Practice Address - Street 1:311 W BROADWAY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2494
Practice Address - Country:US
Practice Address - Phone:989-775-8082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist