Basic Information
| Provider Information | |||||||||
| NPI: | 1598339731 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WESTFALL | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | MAE | ||||||||
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| Credential: | M.S CF-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 DAVIS ST | ||||||||
| Address2: | |||||||||
| City: | NEPTUNE BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322664929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3217042040 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13453 N MAIN ST STE 401 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322182774 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9042498893 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2021 | ||||||||
| LastUpdateDate: | 05/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 235Z00000X | SZ10055 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 390200000X | SZ10055 | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.