Provider Demographics
NPI:1649522590
Name:CAMPOS, LINDSEY MILLER (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:MILLER
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4840
Mailing Address - Country:US
Mailing Address - Phone:562-394-8482
Mailing Address - Fax:
Practice Address - Street 1:8699 HOLDER ST
Practice Address - Street 2:
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90620-3614
Practice Address - Country:US
Practice Address - Phone:714-821-3620
Practice Address - Fax:714-821-5683
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 18834235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist