Provider Demographics
NPI:1770546319
Name:GIBSON TAUCHER, LYNN (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:GIBSON TAUCHER
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E NORTH AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4746
Mailing Address - Country:US
Mailing Address - Phone:412-359-6690
Mailing Address - Fax:412-321-3229
Practice Address - Street 1:420 E NORTH AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4746
Practice Address - Country:US
Practice Address - Phone:412-359-6690
Practice Address - Fax:412-321-3229
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000828L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS186M513Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER