Provider Demographics
NPI:1457682387
Name:MCDONALD, LINDA KAY (SLP-A)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:SLP-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 W SUNNYSLOPE LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-3925
Mailing Address - Country:US
Mailing Address - Phone:623-847-1867
Mailing Address - Fax:
Practice Address - Street 1:10810 N TATUM BLVD
Practice Address - Street 2:#102-185
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6055
Practice Address - Country:US
Practice Address - Phone:480-326-2619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA64342355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant