Provider Demographics
NPI:1164883161
Name:KLAWITTER, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:KLAWITTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10315 STERLING SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2783
Mailing Address - Country:US
Mailing Address - Phone:502-552-9235
Mailing Address - Fax:
Practice Address - Street 1:8910 GREENEWAY COMMONS PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-4065
Practice Address - Country:US
Practice Address - Phone:502-552-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 2935235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist