MEDICARE: LINDA BARRETT

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	20257	MN

General Provider Information

NPI Number	:	1255354155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA BARRETT

Provider Business Mailing Address
First Line	:	403 EVERGREEN DR E
Second Line	:
City	:	CANNON FALLS
State	:	MN
Zip	:	55009-1229
Country	:	US
Telephone Number	:	515-250-4424
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 4TH ST N
Second Line	:
City	:	CANNON FALLS
State	:	MN
Zip	:	55009-2036
Country	:	US
Telephone Number	:	515-250-4424
Fax Number	:

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	05/14/2013

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