Provider Demographics
NPI:1902144769
Name:ROOFF, LINDSEY ANN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:ROOFF
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2571 58TH ST
Mailing Address - Street 2:LOT 1
Mailing Address - City:VINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52349-9326
Mailing Address - Country:US
Mailing Address - Phone:612-849-1036
Mailing Address - Fax:
Practice Address - Street 1:523 E 5TH ST
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-9620
Practice Address - Country:US
Practice Address - Phone:319-624-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002303235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist