Provider Demographics
NPI:1972926160
Name:LULI, LYNSAY MARIE (MA, CFY-SLP)
Entity Type:Individual
Prefix:
First Name:LYNSAY
Middle Name:MARIE
Last Name:LULI
Suffix:
Gender:F
Credentials:MA, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2791 STATE ROUTE 44
Mailing Address - Street 2:
Mailing Address - City:ROOTSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44272-9682
Mailing Address - Country:US
Mailing Address - Phone:330-715-0122
Mailing Address - Fax:
Practice Address - Street 1:61 N CLEVELAND MASSILLON RD UNIT B
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4557
Practice Address - Country:US
Practice Address - Phone:330-668-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2014112-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist