Provider Demographics
NPI:1326564980
Name:RALEY, LYNDY LUREE (SLP)
Entity Type:Individual
Prefix:
First Name:LYNDY
Middle Name:LUREE
Last Name:RALEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72904-4228
Mailing Address - Country:US
Mailing Address - Phone:479-783-7720
Mailing Address - Fax:
Practice Address - Street 1:3300 HARRIS AVE.
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72904
Practice Address - Country:US
Practice Address - Phone:579-783-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-16
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist