Provider Demographics
NPI:1962860411
Name:CALDWELL, LYNDSAY (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LYNDSAY
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 SHORELINE DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-4154
Mailing Address - Country:US
Mailing Address - Phone:248-891-4682
Mailing Address - Fax:
Practice Address - Street 1:640 SHORELINE DR
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-4154
Practice Address - Country:US
Practice Address - Phone:248-891-4682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101002319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist