Provider Demographics
NPI:1497952287
Name:POWERS, LINDSAY MCMILLAN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:MCMILLAN
Last Name:POWERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-2241
Mailing Address - Country:US
Mailing Address - Phone:662-453-9609
Mailing Address - Fax:662-915-5717
Practice Address - Street 1:100 GEORGE HALL REBEL DR
Practice Address - Street 2:
Practice Address - City:UNIVERSITY
Practice Address - State:MS
Practice Address - Zip Code:38677
Practice Address - Country:US
Practice Address - Phone:662-915-7652
Practice Address - Fax:662-915-5715
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3143235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist