Healthcare Provider Details

I. General information

NPI: 1356547665
Provider Name (Legal Business Name): LINDA M. INGRAHAM PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 TURTLE CREEK BLVD SUITE 1026
DALLAS TX
75219-5426
US

IV. Provider business mailing address

3131 TURTLE CREEK BLVD SUITE 1026
DALLAS TX
75219-5426
US

V. Phone/Fax

Practice location:
  • Phone: 214-219-1031
  • Fax: 214-522-0916
Mailing address:
  • Phone: 214-219-1031
  • Fax: 214-522-0916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number22872
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number22872
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: