Provider Demographics
NPI:1720128580
Name:LINCOLN, MARY SCOTT (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:SCOTT
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:SCOTT
Other - Last Name:HUQULEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2523 PEBBLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1246
Mailing Address - Country:US
Mailing Address - Phone:404-993-3055
Mailing Address - Fax:
Practice Address - Street 1:1701 N PATTERSON ST
Practice Address - Street 2:MORE THAN WORDS PEDIATRIC THERAPY ASSOCIATES, INC.
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2940
Practice Address - Country:US
Practice Address - Phone:229-244-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006255235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GASLP006255OtherSLP