Provider Demographics
NPI:1154571107
Name:ABRAHAM, LINZY MARY (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:LINZY
Middle Name:MARY
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 CANYON LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7787
Mailing Address - Country:US
Mailing Address - Phone:919-465-3416
Mailing Address - Fax:
Practice Address - Street 1:412 CANYON LAKE CIR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7787
Practice Address - Country:US
Practice Address - Phone:919-465-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3175235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist