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General NPI Number Information
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NPI Number | 1891908695
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Entity Type | Individual
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Provider Name | LINDA A. DESHETLER PHD
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 1 VA CTR
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City | AUGUSTA
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State | ME
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Zip | 04330-6795
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Country | US
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Telephone | 207-419-9896
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Fax |
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Provider Business Mailing Address
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Address Line | 1 VA CTR
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City | AUGUSTA
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State | ME
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Zip | 04330-6795
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Country | US
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Telephone | 207-419-9896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | 6318
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number | 6318
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6318
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number | 6318
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 6318
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License Number State | OH
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