Provider Demographics
NPI:1003932450
Name:BERTRAM, LINNEA E (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINNEA
Middle Name:E
Last Name:BERTRAM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N705 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53911-9719
Mailing Address - Country:US
Mailing Address - Phone:608-622-7123
Mailing Address - Fax:
Practice Address - Street 1:N705 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53911-9719
Practice Address - Country:US
Practice Address - Phone:608-622-7123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2713-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist