Provider Demographics
NPI:1881720274
Name:KISSANE, LINDA S (AUD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:S
Last Name:KISSANE
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:S
Other - Last Name:SOLCYK SOLCYK-RICE ETCHEVERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 905
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-0905
Mailing Address - Country:US
Mailing Address - Phone:802-748-8141
Mailing Address - Fax:802-748-4098
Practice Address - Street 1:1080 HOSPITAL DR STE 5
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-6001
Practice Address - Country:US
Practice Address - Phone:802-748-5126
Practice Address - Fax:802-748-1107
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1776231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3148486Medicaid
VT6719389Medicaid