Provider Demographics
NPI:1427529692
Name:DICKEY, LINDA ANN (SLP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:DICKEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 GLENVIEW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-1365
Mailing Address - Country:US
Mailing Address - Phone:269-685-5682
Mailing Address - Fax:
Practice Address - Street 1:3260 E B AVE
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-8904
Practice Address - Country:US
Practice Address - Phone:269-349-6649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101002156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist