MEDICARE: DR. LINDA HARTMANN 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	103TC0700X	Clinical Psychologist	4579	OH
2	103G00000X	Clinical Neuropsychologist	4579	OH

General Provider Information

NPI Number	:	1619942638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA HARTMANN PH.D

Provider Business Mailing Address
First Line	:	2810 MACK RD
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5130
Country	:	US
Telephone Number	:	513-874-4530
Fax Number	:	513-346-3811

Provider Business Practice Location Address
First Line	:	2810 MACK RD
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-5130
Country	:	US
Telephone Number	:	513-874-4530
Fax Number	:	513-346-3811

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

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	10/20/2011

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Directions to “ DR. LINDA HARTMANN PH.D” Practice Location

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