Provider Demographics
NPI:1427347921
Name:SANDERS, LINDA SUE (MA, CCC/SLP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:SUE
Last Name:SANDERS
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 1:6140 HIGHWAY 6 # 90
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3802
Mailing Address - Country:US
Mailing Address - Phone:218-403-5437
Mailing Address - Fax:
Practice Address - Street 1:3424 FM 1092 RD STE 200
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2200
Practice Address - Country:US
Practice Address - Phone:281-403-5437
Practice Address - Fax:888-876-2741
Is Sole Proprietor?:No
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11657235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11657OtherTX STATE LICENSE