Provider Demographics
NPI:1558578039
Name:BETTIS, LINDSEY J (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:J
Last Name:BETTIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8855 SOUTHWESTERN BLVD
Mailing Address - Street 2:APT 2272
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-2857
Mailing Address - Country:US
Mailing Address - Phone:214-535-0508
Mailing Address - Fax:
Practice Address - Street 1:2301 MARSH LANE
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093
Practice Address - Country:US
Practice Address - Phone:972-428-1670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist