Healthcare Provider Details

I. General information

NPI: 1588000210
Provider Name (Legal Business Name): LINDA HERBERT PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2013
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 MICHIGAN AVE NW SUITE 5500
WASHINGTON DC
20010-2916
US

IV. Provider business mailing address

111 MICHIGAN AVE NW SUITE 5500
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-4552
  • Fax:
Mailing address:
  • Phone: 202-476-4552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number05166
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: