Provider Demographics
NPI:1265569768
Name:CLEMENT, LYNN A (MHS, SLP-CCC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:MHS, SLP-CCC
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:A
Other - Last Name:SIENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHS, SLP-CCC
Mailing Address - Street 1:1530 NORTHVIEW DR UNIT D8
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-2886
Mailing Address - Country:US
Mailing Address - Phone:907-222-1715
Mailing Address - Fax:
Practice Address - Street 1:600 W 41ST AVE
Practice Address - Street 2:SUITE 102 & 103
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-6601
Practice Address - Country:US
Practice Address - Phone:907-334-9002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist