Provider Demographics
NPI:1538703012
Name:CARLSON, SYDNEY A (SLP)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:A
Last Name:CARLSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:A
Other - Last Name:BREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:PO BOX 5285
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5285
Mailing Address - Country:US
Mailing Address - Phone:402-434-5895
Mailing Address - Fax:
Practice Address - Street 1:4001 O ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1755
Practice Address - Country:US
Practice Address - Phone:402-817-0834
Practice Address - Fax:402-817-0835
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist