Provider Demographics
NPI:1437552270
Name:TRUDEAU, LINDSEY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:TRUDEAU
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:160 JOSEPHINE AVE
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-2834
Mailing Address - Country:US
Mailing Address - Phone:302-047-7626
Mailing Address - Fax:
Practice Address - Street 1:160 JOSEPHINE AVE
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2834
Practice Address - Country:US
Practice Address - Phone:630-204-7762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012123235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist