MEDICARE: LINDA S. WILSON, PHD, PLLC

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	103T00000X	Psychologist	2722	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	50880	OTHER	NC	HEALTH SERVICES PROVIDER - PSYCHOLOGIST

General Provider Information

NPI Number	:	1134401417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA S. WILSON, PHD, PLLC

Provider Business Mailing Address
First Line	:	1011 TUNNEL RD STE 240
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-2060
Country	:	US
Telephone Number	:	828-215-0589
Fax Number	:	828-412-0282

Provider Business Practice Location Address
First Line	:	1011 TUNNEL RD STE 240
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28805-2060
Country	:	US
Telephone Number	:	828-215-0589
Fax Number	:	828-412-0282

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. LINDA S. WILSON
Credential	:	PHD
Telephone Number	:	828-215-0589

Provider Enumeration Date	:	09/13/2011
Last Update Date	:	02/26/2019

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