Provider Demographics
NPI:1669355012
Name:KHAN, LINDA MARIE (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:KHAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28149 SPARROWS EDGE CIR APT 425
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7499
Mailing Address - Country:US
Mailing Address - Phone:727-458-0332
Mailing Address - Fax:
Practice Address - Street 1:3500 E FLETCHER AVE STE 208
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4795
Practice Address - Country:US
Practice Address - Phone:813-252-6334
Practice Address - Fax:813-252-9129
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9259235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty