Provider Demographics
NPI:1336392190
Name:DYKES, LAURINDA JANE (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURINDA
Middle Name:JANE
Last Name:DYKES
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:SKANEATELES
Mailing Address - State:NY
Mailing Address - Zip Code:13152-1305
Mailing Address - Country:US
Mailing Address - Phone:315-685-7928
Mailing Address - Fax:315-218-7644
Practice Address - Street 1:22 E LAKE ST
Practice Address - Street 2:
Practice Address - City:SKANEATELES
Practice Address - State:NY
Practice Address - Zip Code:13152-1305
Practice Address - Country:US
Practice Address - Phone:315-685-7928
Practice Address - Fax:315-218-7644
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012432235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist