Healthcare Provider Details

I. General information

NPI: 1942421318
Provider Name (Legal Business Name): LINDSEY JOHNSON TREADWAY M.S., CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDSEY JOHNSON WEST M.S., CCC/SLP

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 NORTHEAST FRONT STREET
LONOKE AR
72086
US

IV. Provider business mailing address

106 ANDREW RD
ENGLAND AR
72046-1229
US

V. Phone/Fax

Practice location:
  • Phone: 501-743-5283
  • Fax:
Mailing address:
  • Phone: 501-743-5283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2645
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP#P7927
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: