Provider Demographics
NPI:1730309345
Name:DONALDSON, LINDA LEA (MA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEA
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 WYOMING BLVD. NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-369-7001
Mailing Address - Fax:505-856-2037
Practice Address - Street 1:7920 WYOMING BLVD. NE
Practice Address - Street 2:SUITE A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-369-7001
Practice Address - Fax:505-856-2037
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-0327231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000286862OtherANTHEM PROVIDER #
OHDO4018402Medicare ID - Type UnspecifiedMEDICARE