Provider Demographics
NPI:1558797886
Name:STIVERS, LINDSAY LAUREN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:LAUREN
Last Name:STIVERS
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 1:3914 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-2702
Mailing Address - Country:US
Mailing Address - Phone:502-296-0600
Mailing Address - Fax:
Practice Address - Street 1:3914 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-2702
Practice Address - Country:US
Practice Address - Phone:502-296-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3759235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist