Provider Demographics
NPI:1316486699
Name:LINICK, ALISON (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:LINICK
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 1:26705 HURLINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-2455
Mailing Address - Country:US
Mailing Address - Phone:216-577-9099
Mailing Address - Fax:
Practice Address - Street 1:26705 HURLINGHAM RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-2455
Practice Address - Country:US
Practice Address - Phone:216-577-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist