MEDICARE: MS. LINDA LEE HARP MA.,LLP

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	L932669	MI
2	103TC0700X	Clinical Psychologist	6301008612	MI

General Provider Information

NPI Number	:	1790847572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA LEE HARP MA.,LLP

Provider Business Mailing Address
First Line	:	4402 W LAKE MITCHELL DR
Second Line	:
City	:	CADILLAC
State	:	MI
Zip	:	49601-9605
Country	:	US
Telephone Number	:	123-183-2224
Fax Number	:

Provider Business Practice Location Address
First Line	:	4473 220TH AVE
Second Line	:
City	:	REED CITY
State	:	MI
Zip	:	49677-8593
Country	:	US
Telephone Number	:	123-182-3224
Fax Number	:

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	07/08/2007

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