MEDICARE: MS. LINDA SOTO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	35513	TX

General Provider Information

NPI Number	:	1003988965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA SOTO LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1135
Second Line	:
City	:	ROWLETT
State	:	TX
Zip	:	75030-1135
Country	:	US
Telephone Number	:	972-754-9035
Fax Number	:

Provider Business Practice Location Address
First Line	:	2909 COLE AVE
Second Line	:	SUITE 301
City	:	DALLAS
State	:	TX
Zip	:	75204-1189
Country	:	US
Telephone Number	:	972-754-9035
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	07/08/2007

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