MEDICARE: DR. LINDA M HUNTRESS PHD

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
1	235Z00000X	Speech-Language Pathologist	SP0068	OH

General Provider Information

NPI Number	:	1669441440
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA M HUNTRESS PHD

Provider Business Mailing Address
First Line	:	1724 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1865
Country	:	US
Telephone Number	:	513-559-1724
Fax Number	:	513-559-1724

Provider Business Practice Location Address
First Line	:	1724 MADISON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45206-1865
Country	:	US
Telephone Number	:	513-559-1724
Fax Number	:	513-559-1724

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	07/08/2007

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