Healthcare Provider Details

I. General information

NPI: 1467926436
Provider Name (Legal Business Name): LINDSEY WINDSOR CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2019
Last Update Date: 01/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6445 GERMANTOWN AVE
PHILADELPHIA PA
19119-2345
US

IV. Provider business mailing address

134 GRAPE ST
PHILADELPHIA PA
19127-1440
US

V. Phone/Fax

Practice location:
  • Phone: 215-438-5268
  • Fax:
Mailing address:
  • Phone: 410-227-2224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: