Provider Demographics
NPI:1295840643
Name:GANZ, LINDA L (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:GANZ
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 1:1453 EUROPEAN DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4022
Mailing Address - Country:US
Mailing Address - Phone:702-558-9900
Mailing Address - Fax:702-558-9920
Practice Address - Street 1:1340 E PEBBLE RD STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-3145
Practice Address - Country:US
Practice Address - Phone:702-558-9900
Practice Address - Fax:702-675-4999
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV003402217Medicaid
NV003402217Medicaid