Provider Demographics
NPI:1376522375
Name:HALES, LYNN COPONY (MA CCCC SLP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:COPONY
Last Name:HALES
Suffix:
Gender:F
Credentials:MA CCCC SLP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:VOLKMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC SLP
Mailing Address - Street 1:1725 BELLEVUE RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144
Mailing Address - Country:US
Mailing Address - Phone:704-636-9525
Mailing Address - Fax:704-633-2041
Practice Address - Street 1:1725 BELLEVUE RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-636-9525
Practice Address - Fax:704-633-2041
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7438288Medicaid