Doctor Name: | LINDA MARIE HECKENLIVELY |
NPI Number: | 1003294794 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 7424 |
Business Practice Address: | 320 Lennon Ln Walnut Creek, CA - 945982419 |
Business Phone Number: | 9259062268 |
Business Fax Number: | 9259022255 |
Mailing Address: | 7501 May Way, SAN RAMON |
State: | CA |
Postal Code: | 945833709 |
Phone Number: | 9258290779 |
Fax Number: | 9258290779 |
NPI Enumeration Date: | 05/13/2015 |
NPI Last Update Date: | 05/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 7424 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |