Provider Demographics
NPI:1861025702
Name:LINDLEY, EVELYN MICHELLE WEATHERBIE (SLP)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:MICHELLE WEATHERBIE
Last Name:LINDLEY
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 1:10200 MATOCA WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1378
Mailing Address - Country:US
Mailing Address - Phone:512-576-9990
Mailing Address - Fax:
Practice Address - Street 1:1339 LAMAR SQUARE DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2209
Practice Address - Country:US
Practice Address - Phone:512-443-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107559235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist