Provider Demographics
NPI:1154334738
Name:SONG, LINDA ZHIYING (PHD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ZHIYING
Last Name:SONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2466 P.O. BOX
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20891-2466
Mailing Address - Country:US
Mailing Address - Phone:571-331-0312
Mailing Address - Fax:301-760-4457
Practice Address - Street 1:4933 AUBURN AVE.
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:571-331-0312
Practice Address - Fax:301-760-4457
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4917101YM0800X
VA08100003648103TC0700X
MD04454103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical