Provider Demographics
NPI:1639473556
Name:WEIDNER, LYNNE CATHARINE (CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:CATHARINE
Last Name:WEIDNER
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WICKER DR
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9458
Mailing Address - Country:US
Mailing Address - Phone:717-627-1743
Mailing Address - Fax:
Practice Address - Street 1:441 E CHOCOLATE AVE
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1324
Practice Address - Country:US
Practice Address - Phone:717-533-1916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist