Provider Demographics
NPI:1720249170
Name:KNAPP, LINDA KAY (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:KAY
Last Name:KNAPP
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 W ROCKRIMMON BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-1759
Mailing Address - Country:US
Mailing Address - Phone:719-200-6006
Mailing Address - Fax:719-277-7016
Practice Address - Street 1:207 W ROCKRIMMON BLVD STE H
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1759
Practice Address - Country:US
Practice Address - Phone:719-200-6006
Practice Address - Fax:719-277-7016
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO01101685235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20116360380919AOO2OtherTRIWEST/TRICARE PRIME
COCOA100685Medicare PIN