Provider Demographics
NPI:1508285925
Name:MCSTOTTS, LINDSEY PENCE (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:PENCE
Last Name:MCSTOTTS
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WOODBERRY DR SE
Mailing Address - Street 2:
Mailing Address - City:SILVER CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30173-2467
Mailing Address - Country:US
Mailing Address - Phone:706-766-9294
Mailing Address - Fax:
Practice Address - Street 1:505 N 5TH AVE SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-2822
Practice Address - Country:US
Practice Address - Phone:706-291-0521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008227235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist