Provider Demographics
NPI:1437434966
Name:TEARDO, LYNN FRANCES (CCCP/SLP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:FRANCES
Last Name:TEARDO
Suffix:
Gender:F
Credentials:CCCP/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 SE JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-5660
Mailing Address - Country:US
Mailing Address - Phone:772-285-4284
Mailing Address - Fax:
Practice Address - Street 1:2141 SE JACKSON ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-5660
Practice Address - Country:US
Practice Address - Phone:772-285-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5768235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist