MEDICARE: DR. LINDER G HOWZE PSYCHOLOGIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	116142	MS
2	103TB0200X	Cognitive & Behavioral Psychologist	116142	MS
3	103TM1800X	Intellectual & Developmental Disabilities Psychologist	116142	MS
4	103TS0200X	School Psychologist	116142	MS

General Provider Information

NPI Number	:	1083986186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDER G HOWZE PSYCHOLOGIST

Provider Business Mailing Address
First Line	:	1501 FERRIS DR
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2943
Country	:	US
Telephone Number	:	662-402-0119
Fax Number	:

Provider Business Practice Location Address
First Line	:	1501 FERRIS DR
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2943
Country	:	US
Telephone Number	:	662-402-0119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2012
Last Update Date	:	02/04/2012

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