Healthcare Provider Details

I. General information

NPI: 1417299280
Provider Name (Legal Business Name): LINDSEY CASE MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2013
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 RAYBROOK ST SE STE 202
GRAND RAPIDS MI
49546-7717
US

IV. Provider business mailing address

3627 MANDERLEY DR NE
GRAND RAPIDS MI
49525-2033
US

V. Phone/Fax

Practice location:
  • Phone: 616-285-6777
  • Fax: 616-285-6063
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7101001474
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: