Provider Demographics
NPI:1417193509
Name:KIRBY, LINDSAY ANN (MS, TSSLD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ANN
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MS, TSSLD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410-20 FARMERS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-7311
Mailing Address - Country:US
Mailing Address - Phone:631-312-3865
Mailing Address - Fax:
Practice Address - Street 1:10 JAMES ST
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2808
Practice Address - Country:US
Practice Address - Phone:631-669-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018188235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist