Provider Demographics
NPI:1154651016
Name:LINN, DEBRA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:LINN
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 1:14 BIG SKY DRIVE
Mailing Address - Street 2:
Mailing Address - City:GLENDIVE
Mailing Address - State:MT
Mailing Address - Zip Code:59330
Mailing Address - Country:US
Mailing Address - Phone:406-989-0691
Mailing Address - Fax:
Practice Address - Street 1:14 BIG SKY DRIVE
Practice Address - Street 2:
Practice Address - City:GLENDIVE
Practice Address - State:MT
Practice Address - Zip Code:59330
Practice Address - Country:US
Practice Address - Phone:406-989-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT691235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist