Healthcare Provider Details

I. General information

NPI: 1558431775
Provider Name (Legal Business Name): LINDA SUE NEEL ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 S MCCLINTOCK DR SUITE 101
TEMPE AZ
85282-5877
US

IV. Provider business mailing address

4015 S MCCLINTOCK DR SUITE 101
TEMPE AZ
85282-5877
US

V. Phone/Fax

Practice location:
  • Phone: 480-897-6261
  • Fax: 480-897-6284
Mailing address:
  • Phone: 480-897-6261
  • Fax: 480-897-6284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number942
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number942
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: