Basic Information
| Provider Information | |||||||||
| NPI: | 1013316181 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STOTTS | ||||||||
| FirstName: | LINDSAY | ||||||||
| MiddleName: | |||||||||
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| Credential: | MS, SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 511 OLD LANCASTER RD STE 12 | ||||||||
| Address2: | |||||||||
| City: | BERWYN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193121671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102252451 | ||||||||
| FaxNumber: | 6109646166 | ||||||||
| Practice Location | |||||||||
| Address1: | 511 OLD LANCASTER RD STE 12 | ||||||||
| Address2: | |||||||||
| City: | BERWYN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193121671 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102252451 | ||||||||
| FaxNumber: | 6109646166 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2014 | ||||||||
| LastUpdateDate: | 08/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL009026 | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.