Provider Demographics
NPI:1356509301
Name:HAGAR, LINDLEY ROSE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDLEY
Middle Name:ROSE
Last Name:HAGAR
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 1:814 W LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-2415
Mailing Address - Country:US
Mailing Address - Phone:501-943-5920
Mailing Address - Fax:
Practice Address - Street 1:814 W LOCUST ST
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-2415
Practice Address - Country:US
Practice Address - Phone:501-943-5920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP #1281235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist