Provider Demographics
NPI:1396461448
Name:AUGUSTINE, LINDSAY BROOKE (SLP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:BROOKE
Last Name:AUGUSTINE
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 1:1404 CALCUTTA LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2215
Mailing Address - Country:US
Mailing Address - Phone:612-747-2148
Mailing Address - Fax:
Practice Address - Street 1:504 N RIVER RD
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4043
Practice Address - Country:US
Practice Address - Phone:630-548-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist