Provider Demographics
NPI:1487043782
Name:MCCOOL, LINDA (SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MCCOOL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24795 SPADRA LN
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5224
Mailing Address - Country:US
Mailing Address - Phone:949-306-1996
Mailing Address - Fax:
Practice Address - Street 1:24795 SPADRA LN
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5224
Practice Address - Country:US
Practice Address - Phone:949-306-1996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6575235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist