Provider Demographics
NPI:1548410418
Name:BOSSHARDT, LINDA FAYE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:FAYE
Last Name:BOSSHARDT
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 1:1360 EGGERT RD
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3354
Mailing Address - Country:US
Mailing Address - Phone:716-835-0417
Mailing Address - Fax:
Practice Address - Street 1:1360 EGGERT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3354
Practice Address - Country:US
Practice Address - Phone:716-835-0417
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004918-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist