Provider Demographics
NPI:1851512313
Name:LINDBERG, SANDRA L (BS SLP)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:L
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:BS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7250 S KYRENE RD
Mailing Address - Street 2:UNIT # 136
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-4532
Mailing Address - Country:US
Mailing Address - Phone:480-734-9290
Mailing Address - Fax:
Practice Address - Street 1:7250 S KYRENE RD
Practice Address - Street 2:UNIT # 136
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-4532
Practice Address - Country:US
Practice Address - Phone:480-734-9290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL0596235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist