Doctor Name: | MS. LINDA RAE WENNERSTEN |
NPI Number: | 1134244197 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC SLP |
License Number: | SLP1149 |
Business Practice Address: | 11842 N 68th St Scottsdale, AZ - 852545151 |
Business Phone Number: | 4809484264 |
Business Fax Number: | |
Mailing Address: | 11842 N 68th St, SCOTTSDALE |
State: | AZ |
Postal Code: | 852545151 |
Phone Number: | 4809484264 |
Fax Number: | |
NPI Enumeration Date: | 03/20/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP1149 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
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 |