Provider Demographics
NPI:1144610981
Name:HOAG, LINDA KAY
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:KAY
Last Name:HOAG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 20TH ST LOT 767
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-8891
Mailing Address - Country:US
Mailing Address - Phone:772-999-5505
Mailing Address - Fax:
Practice Address - Street 1:7000 20TH ST LOT 767
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-8891
Practice Address - Country:US
Practice Address - Phone:772-999-5505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149007290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health