Lynne Kaulback Orange, M.ED., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Athol, ID
NPI 1497918577 · NPPES record last updated Apr 26, 2023
Key facts
- NPI
- 1497918577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 4048 (ID)
- Practice address
- 11111 E Arroyo LN
Athol, ID 83801-7808 - Phone
- (650) 556-4225
- NPI assigned
- Jul 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16279 | CA | MD | Speech-Language Pathologist |
| 4048 | ID | MD | Speech-Language Pathologist |
| 2202004958 | VA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peninsula Associates Speech Therapy Services, Inc. | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 16279 | CA | |
| Speech-Language Pathologist | 235Z00000X | 2202004958 | VA | |
| Speech-Language Pathologist | 235Z00000X | 4048 | ID | Yes |
Addresses
Primary practice location
11111 E Arroyo LN
Athol, ID 83801-7808
Mailing address
PO Box 982
Athol, ID 83801-0982
Phone (650) 556-4225
Other providers in Athol, ID
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- Hayden Kevin Sharp
- Smiles 4 Miles, LLC
- Kelly Sorensen
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- Charla-Jo Olorenshaw Spradlin
All providers in Athol, ID · Speech-Language Pathologist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.