Provider Demographics
NPI:1790819878
Name:MILLER, LINDA ZIVIC (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ZIVIC
Last Name:MILLER
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 1:8921 BRYSON BEND DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-3601
Mailing Address - Country:US
Mailing Address - Phone:704-341-4765
Mailing Address - Fax:
Practice Address - Street 1:13180 DORMAN RD
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-9327
Practice Address - Country:US
Practice Address - Phone:704-542-0312
Practice Address - Fax:704-542-0313
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist