Provider Demographics
NPI:1417611195
Name:BYOM, LINDSEY JACQUELYN (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:JACQUELYN
Last Name:BYOM
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:JACQUELYN
Other - Last Name:FREDERIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 S COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4309
Mailing Address - Country:US
Mailing Address - Phone:919-962-5965
Mailing Address - Fax:
Practice Address - Street 1:321 S COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4309
Practice Address - Country:US
Practice Address - Phone:919-962-5965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14197235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty