Provider Demographics
NPI:1033424106
Name:MILES, LINDA J (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:MILES
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:486 TURNER CTR RD
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:ME
Mailing Address - Zip Code:04282-3954
Mailing Address - Country:US
Mailing Address - Phone:207-225-3045
Mailing Address - Fax:
Practice Address - Street 1:486 TURNER CTR RD
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:ME
Practice Address - Zip Code:04282-3954
Practice Address - Country:US
Practice Address - Phone:207-225-3045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist