MEDICARE: LINDA DOTSON

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1760979918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA DOTSON

Provider Business Mailing Address
First Line	:	1007 GOULD DR STE 1
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-4971
Country	:	US
Telephone Number	:	318-584-7268
Fax Number	:	318-584-7195

Provider Business Practice Location Address
First Line	:	1007 GOULD DR STE 1
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-4971
Country	:	US
Telephone Number	:	318-584-7268
Fax Number	:	318-584-7195

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

Provider Enumeration Date	:	04/13/2018
Last Update Date	:	04/13/2018

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Directions to “ LINDA DOTSON ” Practice Location

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