Provider Demographics
NPI:1609658111
Name:KEMMERLING, LINDSEY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:KEMMERLING
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N BOULEVARD ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2825
Mailing Address - Country:US
Mailing Address - Phone:970-641-7710
Mailing Address - Fax:
Practice Address - Street 1:800 N BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2825
Practice Address - Country:US
Practice Address - Phone:970-641-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14174142235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist