Provider Demographics
NPI:1154452183
Name:LINDER, LORI R (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:R
Last Name:LINDER
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 N MERAMEC AVE
Mailing Address - Street 2:STE 110A
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3750
Mailing Address - Country:US
Mailing Address - Phone:314-704-5727
Mailing Address - Fax:314-863-7545
Practice Address - Street 1:141 N MERAMEC AVE
Practice Address - Street 2:STE 110A
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3750
Practice Address - Country:US
Practice Address - Phone:314-704-5727
Practice Address - Fax:314-289-7545
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO466919701Medicaid