Provider Demographics
NPI:1174849301
Name:DENCH, LINDA NAYLOR (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:NAYLOR
Last Name:DENCH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:NAYLOR
Other - Last Name:DENCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:4742 HAMILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6022
Mailing Address - Country:US
Mailing Address - Phone:610-336-0133
Mailing Address - Fax:484-395-0156
Practice Address - Street 1:4742 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6022
Practice Address - Country:US
Practice Address - Phone:610-336-0133
Practice Address - Fax:484-395-0156
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-13
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008074101YP2500X
103TE1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACC-AASP #310OtherCC-AASP