Provider Demographics
NPI:1558842971
Name:NEYLAND, LINDSEY (MCD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:NEYLAND
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-2605
Mailing Address - Country:US
Mailing Address - Phone:251-300-9095
Mailing Address - Fax:
Practice Address - Street 1:1405 N 2ND ST
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-4213
Practice Address - Country:US
Practice Address - Phone:618-233-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018019029235Z00000X
IL146.015230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist