Provider Demographics
NPI:1346471703
Name:DICKINSON, LINDSAY COKER (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:COKER
Last Name:DICKINSON
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 1:725 JACKSON ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5761
Mailing Address - Country:US
Mailing Address - Phone:540-693-0527
Mailing Address - Fax:540-319-5454
Practice Address - Street 1:725 JACKSON ST
Practice Address - Street 2:SUITE 218
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5761
Practice Address - Country:US
Practice Address - Phone:540-693-0527
Practice Address - Fax:540-319-5454
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005097235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist