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NPI Code Detail

MEDICARE: MR. WILLIAM R LINZIE M.S.CCC-SLP

MEDICARE:  MR. WILLIAM R LINZIE  M.S.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 Pathologist534NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790831675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WILLIAM R LINZIE M.S.CCC-SLP
Provider Business Mailing Address
First Line : 615 E LINCOLN ST
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4502
Country : US
Telephone Number : 505-426-8095
Fax Number : 505-426-8095
Provider Business Practice Location Address
First Line : 615 E LINCOLN ST
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4502
Country : US
Telephone Number : 505-426-8095
Fax Number : 505-426-8095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 07/08/2007

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Directions to “ MR. WILLIAM R LINZIE M.S.CCC-SLP” Practice Location

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