Healthcare Provider Details

I. General information

NPI: 1295071777
Provider Name (Legal Business Name): LINDSEY SHIVER HOBDY MED CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 N PATTERSON ST
VALDOSTA GA
31601-4528
US

IV. Provider business mailing address

809 NORTH PATTERSON STREET
VALDOSTA GA
31601-4528
US

V. Phone/Fax

Practice location:
  • Phone: 229-469-6932
  • Fax:
Mailing address:
  • Phone: 229-469-6932
  • Fax: 229-469-6933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP008392
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: