Provider Demographics
NPI:1346798089
Name:RUMMEL, LYNN DEVANE (MED, MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:DEVANE
Last Name:RUMMEL
Suffix:
Gender:F
Credentials:MED, 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 1:455 GREYSTONE CT SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-3946
Mailing Address - Country:US
Mailing Address - Phone:772-323-1228
Mailing Address - Fax:
Practice Address - Street 1:4957 5TH MNR
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968-1132
Practice Address - Country:US
Practice Address - Phone:772-323-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15986235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist