Provider Demographics
NPI:1356695019
Name:LILE, LINDSEY
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:LILE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3271 ALVEY PARK DR W
Mailing Address - Street 2:SUITE H
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-2466
Mailing Address - Country:US
Mailing Address - Phone:270-683-9992
Mailing Address - Fax:270-683-9993
Practice Address - Street 1:3271 ALVEY PARK DR W
Practice Address - Street 2:SUITE H
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-2466
Practice Address - Country:US
Practice Address - Phone:270-683-9992
Practice Address - Fax:270-683-9993
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY12-012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist