Provider Demographics
NPI:1841783966
Name:HALL, LINDSEY BROOKE (MED, CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:BROOKE
Last Name:HALL
Suffix:
Gender:F
Credentials:MED, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 STUART AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-3440
Mailing Address - Country:US
Mailing Address - Phone:757-681-5696
Mailing Address - Fax:
Practice Address - Street 1:13700 N GAYTON RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-7017
Practice Address - Country:US
Practice Address - Phone:804-360-1960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist