Provider Demographics
NPI:1447312954
Name:HALL, LINDSEY MUELLER (MS, CCCSLP)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MUELLER
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1583 FEARN CIR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3509
Mailing Address - Country:US
Mailing Address - Phone:404-985-5701
Mailing Address - Fax:
Practice Address - Street 1:1583 FEARN CIR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-3509
Practice Address - Country:US
Practice Address - Phone:404-985-5701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006507235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA909434570AMedicaid