Basic Information
Provider Information
NPI: 1295081172
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EKEY
FirstName: LINDSAY
MiddleName: ANN
NamePrefix: DR.
NameSuffix:  
Credential: AUD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ROBINSON
OtherFirstName: LINDSAY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 190 RIVERSIDE ST
Address2: SUITE 6B
City: PORTLAND
State: ME
PostalCode: 041031073
CountryCode: US
TelephoneNumber: 2076612000
FaxNumber:  
Practice Location
Address1: 1250 FOREST AVE
Address2: SUITE 301
City: PORTLAND
State: ME
PostalCode: 041031889
CountryCode: US
TelephoneNumber: 2077975753
FaxNumber: 2077979571
Other Information
ProviderEnumerationDate: 07/30/2012
LastUpdateDate: 04/27/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X984MAN Speech, Language and Hearing Service ProvidersAudiologist 
231H00000XAP2234MEY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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