Provider Demographics
NPI:1972134666
Name:GABBARD, LINDSEY (SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:GABBARD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:RUTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10094 TERRAPIN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-8995
Mailing Address - Country:US
Mailing Address - Phone:248-709-3575
Mailing Address - Fax:
Practice Address - Street 1:806 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BERRYVILLE
Practice Address - State:AR
Practice Address - Zip Code:72616-3107
Practice Address - Country:US
Practice Address - Phone:870-423-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR14335302235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist