Provider Demographics
NPI:1760510507
Name:MYERS, LINDA CAROL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:CAROL
Last Name:MYERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5302 CRAIGS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-4841
Mailing Address - Country:US
Mailing Address - Phone:502-412-0292
Mailing Address - Fax:502-412-0292
Practice Address - Street 1:5302 CRAIGS CREEK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-4841
Practice Address - Country:US
Practice Address - Phone:502-412-0292
Practice Address - Fax:502-412-0292
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0560235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist