Provider Demographics
NPI:1326243304
Name:QUAM, LINDA ANN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:QUAM
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:ANN
Other - Last Name:GIEBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:410 S THIRD ST
Mailing Address - Street 2:SPEECH & HEARING CLINIC VW RIVER FALLS
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022
Mailing Address - Country:US
Mailing Address - Phone:715-425-3801
Mailing Address - Fax:715-425-3800
Practice Address - Street 1:410 S THIRD ST
Practice Address - Street 2:SPEECH & HEARING CLINIC VW RIVER FALLS
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022
Practice Address - Country:US
Practice Address - Phone:715-425-3801
Practice Address - Fax:715-425-3800
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI987154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN16G94G1OtherBCBS