Provider Demographics
NPI:1780895250
Name:BLUNDI, LINDSAY DARA (MA CCC SLP)
Entity type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:DARA
Last Name:BLUNDI
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 1:1704 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966-4033
Mailing Address - Country:US
Mailing Address - Phone:215-357-3339
Mailing Address - Fax:
Practice Address - Street 1:1704 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:PA
Practice Address - Zip Code:18966-4033
Practice Address - Country:US
Practice Address - Phone:215-357-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008827235Z00000X
NJ41YS00518900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ41YS00518900OtherSPEECH PATHOLOGY
PASL008827OtherSPEECH PATHOLOGY