Provider Demographics
NPI:1982867867
Name:HAMERNIK, LINDA A (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:A
Last Name:HAMERNIK
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 1:3510 31ST AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34117-8454
Mailing Address - Country:US
Mailing Address - Phone:239-455-4125
Mailing Address - Fax:239-455-4125
Practice Address - Street 1:3510 31ST AVE SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34117-8454
Practice Address - Country:US
Practice Address - Phone:239-455-4125
Practice Address - Fax:239-455-4125
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6691235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist