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General NPI Number Information
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NPI Number | 1790913457
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Entity Type | Individual
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Provider Name | LYNSIE CLEAVINGER MS, CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 514 W AVENUE G
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City | MULESHOE
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State | TX
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Zip | 79347-3445
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Country | US
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Telephone | 806-272-7323
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Fax | 806-272-5634
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Provider Business Mailing Address
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Address Line | 2325 COUNTY ROAD V
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City | FRIONA
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State | TX
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Zip | 79035-7531
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Country | US
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Telephone | 68-344-1343
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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 | 103220
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License Number State | TX
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