Healthcare Provider Details

I. General information

NPI: 1154453835
Provider Name (Legal Business Name): LINDA JOSEPHINE OXFORD MED LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA OXFORD WALTON MED LMFT

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 A EAST PARK AVE
TALLAHASSEE FL
32301
US

IV. Provider business mailing address

2017 MISTY HOLLOW
TALLAHASSEE FL
32312
US

V. Phone/Fax

Practice location:
  • Phone: 850-681-0458
  • Fax: 801-681-0451
Mailing address:
  • Phone: 850-893-4383
  • Fax: 801-681-0451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT1261
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: