Provider Demographics
NPI:1184916942
Name:ISON, LINDSEY A (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:A
Last Name:ISON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:A
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:213 W DURHAM ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-3410
Mailing Address - Country:US
Mailing Address - Phone:918-710-0764
Mailing Address - Fax:
Practice Address - Street 1:213 W DURHAM ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74011-3410
Practice Address - Country:US
Practice Address - Phone:918-928-9767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3620235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist