MEDICARE: MS. LINDA WISHART MS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1750663498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA WISHART MS

Provider Business Mailing Address
First Line	:	PO BOX 1136
Second Line	:
City	:	SILVER SPRINGS
State	:	NV
Zip	:	89429-1136
Country	:	US
Telephone Number	:	775-577-0319
Fax Number	:	775-577-9571

Provider Business Practice Location Address
First Line	:	3595 HWY 50 WEST STE. 3
Second Line	:
City	:	SILVER SPRINGS
State	:	NV
Zip	:	89429-1136
Country	:	US
Telephone Number	:	775-577-0319
Fax Number	:	775-577-9571

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

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	11/29/2012

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Directions to “ MS. LINDA WISHART MS” Practice Location

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