Provider Demographics
NPI:1013465467
Name:CARAHALY, LYNN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:CARAHALY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3459 S EUCALYPTUS PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-2369
Mailing Address - Country:US
Mailing Address - Phone:602-502-1322
Mailing Address - Fax:
Practice Address - Street 1:4100 S LINDSAY RD
Practice Address - Street 2:STE 113
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-1506
Practice Address - Country:US
Practice Address - Phone:480-219-3953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP4221235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist