=====================================================
General NPI Number Information
=====================================================
NPI Number | 1396949251
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDA L KURIAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4861 HIGHWAY 224
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64097-9119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-922-4488
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 423
-----------------------------------------------------
City | WELLINGTON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64097-0423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-922-4488
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 2007015277
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------