Provider Demographics
NPI:1437453347
Name:ROBERTS, LYNN ANN (SLP, CCC)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ANN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:SLP, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 BARLOW CT
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-1501
Mailing Address - Country:US
Mailing Address - Phone:559-889-9561
Mailing Address - Fax:
Practice Address - Street 1:1419 BARLOW CT
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-1501
Practice Address - Country:US
Practice Address - Phone:559-889-9561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1081235Z00000X
IA00260235Z00000X
FLSA10792235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist