Provider Demographics
NPI:1548097371
Name:BAGLIETTO-DUBIE, LINDSAY (MS)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:BAGLIETTO-DUBIE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:BAGLIETTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:947 MASON ST
Mailing Address - Street 2:
Mailing Address - City:MYRTLE CREEK
Mailing Address - State:OR
Mailing Address - Zip Code:97457-9384
Mailing Address - Country:US
Mailing Address - Phone:541-863-0212
Mailing Address - Fax:
Practice Address - Street 1:1871 NE STEPHENS ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-1433
Practice Address - Country:US
Practice Address - Phone:541-440-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16878235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist