Provider Demographics
NPI:1336477116
Name:ABBAS, LINDSEY DIANE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:DIANE
Last Name:ABBAS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 CARDINAL DRIVE CIR
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-3832
Mailing Address - Country:US
Mailing Address - Phone:605-216-2924
Mailing Address - Fax:
Practice Address - Street 1:514 CARDINAL DRIVE CIR
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-3832
Practice Address - Country:US
Practice Address - Phone:605-216-2924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-06
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD12093152235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist