Lindsey Rausch Dereadt, CCC-SLP
Speech-Language Pathologist, in San Antonio, TX. Individual provider (NPI-1).
NPI number1790448751
StatusActive
Last updated in NPPESOct 18, 2021
Details
- NPI
- 1790448751
- Entity type
- Individual (NPI-1)
- Name
- Lindsey Rausch Dereadt
- Credential
- CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 18, 2021
- Certification date
- Oct 18, 2021
- Last updated
- Oct 18, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 111587 | TX | Yes |
Practice location
8961 Tesoro DrSan Antonio, TX 78217-6209
Phone 210-407-0441
Mailing address
181 Westcourt LnSan Antonio, TX 78257-1373
Phone 210-827-4132
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