Provider Demographics
NPI:1972804391
Name:BEAUDIN, LINDA J (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:J
Last Name:BEAUDIN
Suffix:
Gender:F
Credentials: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:P.O. BOX 45892
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68145
Mailing Address - Country:US
Mailing Address - Phone:801-652-3532
Mailing Address - Fax:
Practice Address - Street 1:15681 SPAULDING ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-8411
Practice Address - Country:US
Practice Address - Phone:801-652-3532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist