Provider Demographics
NPI:1548902695
Name:REMINGTON, LYNN WENDY (MA/CCC/SLP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:WENDY
Last Name:REMINGTON
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 1:2 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5204
Mailing Address - Country:US
Mailing Address - Phone:973-768-3195
Mailing Address - Fax:
Practice Address - Street 1:2 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5204
Practice Address - Country:US
Practice Address - Phone:973-768-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-10
Last Update Date:2022-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00294500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist