MEDICARE: LINDA G. COMBS PH.D.

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	106H00000X	Marriage & Family Therapist	065	NC

General Provider Information

NPI Number	:	1356534978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA G. COMBS PH.D.

Provider Business Mailing Address
First Line	:	216 N MCDOWELL ST STE 204
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2260
Country	:	US
Telephone Number	:	704-372-9782
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 N MCDOWELL ST STE 204
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2260
Country	:	US
Telephone Number	:	704-372-9782
Fax Number	:

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

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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