Provider Demographics
NPI:1730652587
Name:LYNCH, NANCY (MA, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MA, CCC-SLP/L
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP/L
Mailing Address - Street 1:15100 S 94TH AVE ORLAND SCHOOL DISTRICT 135
Mailing Address - Street 2:
Mailing Address - City:ORLOND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462
Mailing Address - Country:US
Mailing Address - Phone:708-364-3330
Mailing Address - Fax:
Practice Address - Street 1:15100 S 94TH AVE ORLAND SCHOOL DISTRICT 135
Practice Address - Street 2:
Practice Address - City:ORLOND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462
Practice Address - Country:US
Practice Address - Phone:708-364-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146000250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist