Basic Information
| Provider Information | |||||||||
| NPI: | 1174731376 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIMLER | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | EDWARDS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AUD, CCC-A, FAAA/ABA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1320 OLD CHAIN BRIDGE RD STE 185 | ||||||||
| Address2: | |||||||||
| City: | MC LEAN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221013945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039428110 | ||||||||
| FaxNumber: | 7039428042 | ||||||||
| Practice Location | |||||||||
| Address1: | 46045 PALISADE PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | POTOMAC FALLS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201658762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037239672 | ||||||||
| FaxNumber: | 7037240127 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2007 | ||||||||
| LastUpdateDate: | 09/28/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/28/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 2101000599 | VA | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 2201000365 | VA | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | Q37135A827 | 01 | VA | MEDICARE | OTHER |