Provider Demographics
NPI:1659629244
Name:CAYWOOD, LILY (MS)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:
Last Name:CAYWOOD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9700 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:STAR
Mailing Address - State:ID
Mailing Address - Zip Code:83669-5766
Mailing Address - Country:US
Mailing Address - Phone:208-830-1092
Mailing Address - Fax:208-545-7505
Practice Address - Street 1:9700 W STATE ST
Practice Address - Street 2:
Practice Address - City:STAR
Practice Address - State:ID
Practice Address - Zip Code:83669-5766
Practice Address - Country:US
Practice Address - Phone:208-830-1092
Practice Address - Fax:208-545-7505
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDTSLP-2300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist