Provider Demographics
NPI:1992202451
Name:LAWLER, CINDY (SLP)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:LAWLER
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 1:926 LAKE WASHINGTON RD W
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLAN
Mailing Address - State:MS
Mailing Address - Zip Code:38744-9782
Mailing Address - Country:US
Mailing Address - Phone:662-379-3306
Mailing Address - Fax:
Practice Address - Street 1:926 LAKE WASHINGTON RD W
Practice Address - Street 2:
Practice Address - City:GLEN ALLAN
Practice Address - State:MS
Practice Address - Zip Code:38744
Practice Address - Country:US
Practice Address - Phone:662-379-3306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4358235Z00000X
MS137536235Z00000X
MSS0718235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist