Provider Demographics
NPI:1790351120
Name:HICKSON, LINDSEY (AUD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:HICKSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:BITTINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:117 E KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-2793
Mailing Address - Country:US
Mailing Address - Phone:502-371-9910
Mailing Address - Fax:502-515-3325
Practice Address - Street 1:117 E KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2793
Practice Address - Country:US
Practice Address - Phone:502-371-9910
Practice Address - Fax:502-515-3325
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY270068231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty