| Doctor Name: | LUCINDA CARLSON |
| NPI Number: | 1285064808 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SLP-1325 |
| Business Practice Address: | 1952 East 7000 South Salt Lake City, UT - 84121 |
| Business Phone Number: | 8554409677 |
| Business Fax Number: | 8014955303 |
| Mailing Address: | 415 Warner Ave, LEWISTON |
| State: | ID |
| Postal Code: | 835014415 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/18/2013 |
| NPI Last Update Date: | 11/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP-1325 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |