Doctor Name: | MRS. LYNNETTE M CREED |
NPI Number: | 1407917321 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 108892 |
Business Practice Address: | 704 W Boulevard St Mexico, MO - 652652192 |
Business Phone Number: | 5735813773 |
Business Fax Number: | 5735814410 |
Mailing Address: | 920 S Jefferson St, MEXICO |
State: | MO |
Postal Code: | 652652563 |
Phone Number: | 5735813773 |
Fax Number: | 5735814410 |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 108892 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
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 |