Individual
MRS. LYNDA DIANE MANISCALCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
9221 CHAMPION CIR. SOUTH, MOBILE, AL 36695
(251) 599-5953
Mailing address
9221 CHAMPION CIR. S., MOBILE, AL 36695
(251) 599-5953
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1873
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-36292
BLUE CROSS BLUE SHIELD PROVIDER #
AL
01
—
93901
BLUE CROSS BLUE SHIELD UPIN #
AL
Enumeration date
09/05/2008
Last updated
09/05/2008
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