Provider Demographics
NPI:1669038196
Name:GONZALEZ, LYNZY ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LYNZY
Middle Name:ANN
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:LYNZY
Other - Middle Name:ANN
Other - Last Name:MELZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4402 WILLIAMS DRIVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628
Mailing Address - Country:US
Mailing Address - Phone:512-256-7627
Mailing Address - Fax:512-375-3291
Practice Address - Street 1:4402 WILLIAMS DRIVE
Practice Address - Street 2:SUITE 115
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628
Practice Address - Country:US
Practice Address - Phone:512-256-7627
Practice Address - Fax:512-375-3291
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12777235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist