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General NPI Number Information
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NPI Number | 1104690908
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Entity Type | Individual
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Provider Name | LINDA HAMILTON M.S.,CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 401 S 33RD ST
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City | FORT PIERCE
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State | FL
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Zip | 34947-3536
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Country | US
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Telephone | 772-461-2232
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Fax |
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Provider Business Mailing Address
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Address Line | 10635 PINE NEEDLE DR
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City | FORT PIERCE
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State | FL
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Zip | 34945-2200
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Country | US
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Telephone | 772-206-1418
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA5972
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License Number State | FL
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