Provider Demographics
NPI:1447696299
Name:RYSBERG, LINDA (SLP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:RYSBERG
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 1:2489 N US HWY 31 N
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3700
Mailing Address - Country:US
Mailing Address - Phone:231-938-9218
Mailing Address - Fax:
Practice Address - Street 1:2489 N US HWY 31 N
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3700
Practice Address - Country:US
Practice Address - Phone:231-938-9218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist