Provider Demographics
NPI:1558691428
Name:APPLEBEE, LYNN ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ANN
Last Name:APPLEBEE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:ANN
Other - Last Name:SUMMERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5733 RIVERBOAT CIR SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-7524
Mailing Address - Country:US
Mailing Address - Phone:772-492-3975
Mailing Address - Fax:772-925-8259
Practice Address - Street 1:5733 RIVERBOAT CIR SW
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32968
Practice Address - Country:US
Practice Address - Phone:772-492-3975
Practice Address - Fax:772-925-8259
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA8774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001727800Medicaid