Provider Demographics
NPI:1396413571
Name:VENABLE, LYNNE
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:
Last Name:VENABLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20710 CAMEL BACK ST
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-5841
Mailing Address - Country:US
Mailing Address - Phone:737-932-3073
Mailing Address - Fax:
Practice Address - Street 1:20311 DAWN DR
Practice Address - Street 2:
Practice Address - City:LAGO VISTA
Practice Address - State:TX
Practice Address - Zip Code:78645-5277
Practice Address - Country:US
Practice Address - Phone:512-267-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant