Provider Demographics
NPI:1770828790
Name:LITWINCZYK, LYNN ANN (SLP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:LITWINCZYK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 HOPMEADOW RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-2209
Mailing Address - Country:US
Mailing Address - Phone:860-582-0546
Mailing Address - Fax:
Practice Address - Street 1:124 HOPMEADOW RD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-2209
Practice Address - Country:US
Practice Address - Phone:860-582-0546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-02
Last Update Date:2012-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002474235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist