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General NPI Number Information
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NPI Number | 1144351594
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Entity Type | Individual
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Provider Name | LYNSEY LEE BATES MS CCCSLP
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 01/06/2011
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Provider Practice Location Address
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Address Line | 1616 NORTH VINE
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City | MAGNOLIA
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State | AR
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Zip | 71753-9740
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Country | US
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Telephone | 870-234-8979
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Fax | 870-234-0118
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Provider Business Mailing Address
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Address Line | 173 PATTERSON LOOP
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City | EL DORADO
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State | AR
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Zip | 71730-8477
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Country | US
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Telephone | 870-863-3367
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Fax | 870-863-3367
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP2136
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License Number State | AR
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