Basic Information
Provider Information
NPI: 1548516792
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: LINDA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 ROYAL TOWER DR
Address2:  
City: HOMEWOOD
State: AL
PostalCode: 352096865
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 245 CAHABA VALLEY PKWY
Address2: SUITE 200
City: PELHAM
State: AL
PostalCode: 351242216
CountryCode: US
TelephoneNumber: 2059426820
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2012
LastUpdateDate: 07/25/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X813ALY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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