Basic Information
Provider Information
NPI: 1528300720
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PAUL
FirstName: LINDA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: SPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 EAST KINGS HIGHWAY
Address2: 2ND FLOOR SUITE 205
City: CHERRY HILL
State: NJ
PostalCode: 08034
CountryCode: US
TelephoneNumber: 8563481170
FaxNumber: 8562161269
Practice Location
Address1: 201 SOUTH KINGS HIGHWAY
Address2:  
City: HADDONFILELD
State: NJ
PostalCode: 08033
CountryCode: US
TelephoneNumber: 8563481170
FaxNumber: 8562161269
Other Information
ProviderEnumerationDate: 03/26/2013
LastUpdateDate: 03/26/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X41YS00068700NJY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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