Provider Demographics
NPI:1962634279
Name:ANDRUCHUVE, LINDSAY C (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:C
Last Name:ANDRUCHUVE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2007
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02881-0495
Mailing Address - Country:US
Mailing Address - Phone:401-263-6839
Mailing Address - Fax:
Practice Address - Street 1:180 BISCUIT CITY RD
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881-1639
Practice Address - Country:US
Practice Address - Phone:401-263-6839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEPT HEALTH: SP00974235Z00000X
RIDEPT ED: 51809235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist