Provider Demographics
NPI:1144466913
Name:RASKIN, LYNNE G (MS,MA,SLP)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:G
Last Name:RASKIN
Suffix:
Gender:F
Credentials:MS,MA,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SUNSET HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-5027
Mailing Address - Country:US
Mailing Address - Phone:845-677-0071
Mailing Address - Fax:
Practice Address - Street 1:99 SUNSET HILL RD
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12569-5027
Practice Address - Country:US
Practice Address - Phone:845-677-0071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000969252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency