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NPI Code Detail

MEDICARE: LINDY LOU WELLNESS

MEDICARE: LINDY LOU WELLNESS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0700XHearing and Speech Clinic/Center

General Provider Information

NPI Number : 1609343417
Entity Type Code : Organization
Provider Name (Legal Business Name) : LINDY LOU WELLNESS
Provider Business Mailing Address
First Line : 7113 DEVILLE DR
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-8283
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7113 DEVILLE DR
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-8283
Country : US
Telephone Number : 214-763-1776
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KRISTAN WILLIAMS KASZYNSKI
Credential : MS CCC-SLP
Telephone Number : 214-763-1776
Provider Enumeration Date : 10/30/2018
Last Update Date : 10/30/2018

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