Basic Information
Provider Information
NPI: 1962745307
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELANGELO THOMPSON
FirstName: LINDSAY
MiddleName: JO
NamePrefix: MRS.
NameSuffix:  
Credential: M.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1043 PELICAN HILL LN APT A
Address2:  
City: WEBSTER
State: NY
PostalCode: 145802987
CountryCode: US
TelephoneNumber: 9063614194
FaxNumber:  
Practice Location
Address1: 41 COLEBROOK DR
Address2:  
City: ROCHESTER
State: NY
PostalCode: 146172211
CountryCode: US
TelephoneNumber: 5854674567
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/04/2013
LastUpdateDate: 04/04/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X  Y Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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