Basic Information
Provider Information
NPI: 1003003468
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BESTE
FirstName: LINDA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 190
Address2:  
City: WHITERIVER
State: AZ
PostalCode: 859410190
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 392 S CHIEF AVE
Address2:  
City: WHITERIVER
State: AZ
PostalCode: 85941
CountryCode: US
TelephoneNumber: 9283381026
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/01/2007
LastUpdateDate: 10/01/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000XSLP0006AZY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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