Provider Demographics
NPI:1932569274
Name:DUES, LYNELLE MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LYNELLE
Middle Name:MARIE
Last Name:DUES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 HAY RD
Mailing Address - Street 2:
Mailing Address - City:HARROD
Mailing Address - State:OH
Mailing Address - Zip Code:45850-9755
Mailing Address - Country:US
Mailing Address - Phone:419-296-0572
Mailing Address - Fax:
Practice Address - Street 1:1920 SLABTOWN RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-3309
Practice Address - Country:US
Practice Address - Phone:419-222-1836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2016168235Z00000X
OH12471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist