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NPI Code Detail

MEDICARE: MRS. AMBER MICHELLE LINN MCD, CCC-SLP

MEDICARE: MRS. AMBER MICHELLE LINN MCD, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist6267LA

General Provider Information

NPI Number : 1407134810
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMBER MICHELLE LINN MCD, CCC-SLP
Provider Business Mailing Address
First Line : 565 WHITEFIELD LN
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71112-4281
Country : US
Telephone Number : 318-423-1994
Fax Number :
Provider Business Practice Location Address
First Line : 2522 E 70TH ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-4002
Country : US
Telephone Number : 318-795-3388
Fax Number : 318-795-3399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2011
Last Update Date : 08/02/2011

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Directions to “ MRS. AMBER MICHELLE LINN MCD, CCC-SLP” Practice Location

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