Provider Demographics
NPI:1336309533
Name:MANN, LINDA L I (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:L
Last Name:MANN
Suffix:I
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 1ST ST
Mailing Address - Street 2:
Mailing Address - City:KEYPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:07735-1586
Mailing Address - Country:US
Mailing Address - Phone:908-337-3100
Mailing Address - Fax:
Practice Address - Street 1:20 1ST ST
Practice Address - Street 2:
Practice Address - City:KEYPORT
Practice Address - State:NJ
Practice Address - Zip Code:07735-1586
Practice Address - Country:US
Practice Address - Phone:908-337-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00492800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist