Provider Demographics
NPI:1063621274
Name:KUSHNER, LINDA ROSS (MA CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ROSS
Last Name:KUSHNER
Suffix:
Gender:F
Credentials:MA CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 VILLAGE SQUARE CROSSING
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-627-7899
Mailing Address - Fax:561-318-7827
Practice Address - Street 1:500 VILLAGE SQUARE CROSSING
Practice Address - Street 2:SUITE 201
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4548
Practice Address - Country:US
Practice Address - Phone:561-627-7899
Practice Address - Fax:561-318-7827
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 1789235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist