Provider Demographics
NPI:1467573162
Name:WEINER, LINDA E (EDD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:E
Last Name:WEINER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 N BELFIELD AVE
Mailing Address - Street 2:SUNNY DAYS
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4904
Mailing Address - Country:US
Mailing Address - Phone:610-449-1600
Mailing Address - Fax:610-449-2655
Practice Address - Street 1:7901 HENRY AVE APT E412
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-6082
Practice Address - Country:US
Practice Address - Phone:215-487-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000203L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist