Provider Demographics
NPI:1750870929
Name:MONROE, LINDSAY B (MA, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:B
Last Name:MONROE
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 1:107 DEVON WAY
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-4411
Mailing Address - Country:US
Mailing Address - Phone:864-314-5961
Mailing Address - Fax:
Practice Address - Street 1:414 SUMMIT DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-4821
Practice Address - Country:US
Practice Address - Phone:864-271-7562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist