Lacy Olivia Flynn, M.A. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · French Lick, IN

NPI 1649576174 · NPPES record last updated Mar 16, 2021

Key facts

NPI
1649576174
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
5085-154 (WI)
Practice address
457 S State Road 145
French Lick, IN 47432-1036
Phone
(812) 936-9666
NPI assigned
Feb 1, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22004475AINMDSpeech-Language Pathologist
5085-154WIMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22004475A IN
Speech-Language Pathologist 235Z00000X 5085-154 WI Yes

Addresses

Primary practice location

457 S State Road 145
French Lick, IN 47432-1036

Mailing address

650 Pearl St
Rib Lake, WI 54470-9322
Phone (715) 427-5291

Other providers in French Lick, IN

All providers in French Lick, IN · Speech-Language Pathologist in Indiana

Sources for this page

Verify at the official NPI Registry.