Provider Demographics
NPI:1023679438
Name:FOOTE, LINDSEY TAYLOR (SLP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:TAYLOR
Last Name:FOOTE
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 1:6502 SLIDE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1311
Mailing Address - Country:US
Mailing Address - Phone:806-698-0864
Mailing Address - Fax:
Practice Address - Street 1:6502 SLIDE RD STE 204
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-1311
Practice Address - Country:US
Practice Address - Phone:806-698-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115628235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist