Provider Demographics
NPI:1922560911
Name:LINDE, AMY MORGAN (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MORGAN
Last Name:LINDE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ROSE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:270 HENRY AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-4711
Mailing Address - Country:US
Mailing Address - Phone:847-722-4729
Mailing Address - Fax:
Practice Address - Street 1:270 HENRY AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4711
Practice Address - Country:US
Practice Address - Phone:847-722-4729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist