Provider Demographics
NPI:1043456411
Name:NEWMAN, LINDA L (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 DISTIN AVE
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-1669
Mailing Address - Country:US
Mailing Address - Phone:907-209-7555
Mailing Address - Fax:
Practice Address - Street 1:9109 MENDENHALL MALL RD
Practice Address - Street 2:SUITE 5K
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7113
Practice Address - Country:US
Practice Address - Phone:907-209-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK754225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist