Provider Demographics
NPI:1093939423
Name:STOER SCAGGS, LINDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:STOER SCAGGS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:L
Other - Last Name:SCAGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:98 WEXFORD DRIVE
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023
Mailing Address - Country:US
Mailing Address - Phone:614-638-4752
Mailing Address - Fax:
Practice Address - Street 1:1350 WEST FIFTH AVENUE
Practice Address - Street 2:SUITE 10C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212
Practice Address - Country:US
Practice Address - Phone:614-638-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor