Provider Demographics
NPI:1417374364
Name:BACKUS, LINDSAY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:BACKUS
Suffix:
Gender:F
Credentials: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 1:1303 PENNOCK AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37207-5123
Mailing Address - Country:US
Mailing Address - Phone:318-243-4395
Mailing Address - Fax:
Practice Address - Street 1:125 ISLAND DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4544
Practice Address - Country:US
Practice Address - Phone:615-714-9224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4772235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist