Individual
LINDA CHARLEBOIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-A
Contact information
Practice address
6301 UNIVERSITY COMMONS, SUITE 360, SOUTH BEND, IN 46635-1571
(574) 232-4800
(574) 288-7143
Mailing address
6301 UNIVERSITY COMMONS, SUITE 230, SOUTH BEND, IN 46635-1571
(574) 251-2100
(574) 251-2150
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
23002524A
IN
237600000X
Audiologist-Hearing Aid Fitter
23002524A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000798626
ANTHEM PROVIDER NUMBER
IN
05
—
201126970
—
IN
Enumeration date
12/17/2012
Last updated
09/09/2015
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