Provider Demographics
NPI:1043431141
Name:KNOWLES, LINDA LS (LLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LS
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:MRS
Other - First Name:JENNI
Other - Middle Name:
Other - Last Name:KNOWLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLP
Mailing Address - Street 1:6633 ELLINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48383-3083
Mailing Address - Country:US
Mailing Address - Phone:248-320-1196
Mailing Address - Fax:248-889-1785
Practice Address - Street 1:32000 NORTHWESTERN HWY STE 165
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1568
Practice Address - Country:US
Practice Address - Phone:248-320-1196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012023103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist