Provider Demographics
NPI:1275774184
Name:CIMARUSTI, LINDA JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JEAN
Last Name:CIMARUSTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARYLINDA
Other - Middle Name:
Other - Last Name:CIMARUSTI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7910 WOODMONT AVE
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3002
Mailing Address - Country:US
Mailing Address - Phone:301-509-8592
Mailing Address - Fax:310-229-9008
Practice Address - Street 1:7910 WOODMONT AVE
Practice Address - Street 2:SUITE 1101
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3002
Practice Address - Country:US
Practice Address - Phone:301-509-8592
Practice Address - Fax:310-229-9008
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-23
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01674103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical