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General NPI Number Information
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NPI Number | 1689329906
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Entity Type | Individual
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Provider Name | LYDIA ERIN WHITE M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 03/10/2023
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Provider Practice Location Address
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Address Line | 4680 LAKE UNDERHILL ROAD
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City | ORLANDO
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State | FL
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Zip | 32807-1182
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Country | US
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Telephone | 407-904-0137
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Fax |
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Provider Business Mailing Address
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Address Line | 4780 DATA CT
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City | ORLANDO
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State | FL
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Zip | 32817-8331
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Country | US
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Telephone |
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Fax |
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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 |
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License Number State | FL
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