Provider Demographics
NPI:1285014134
Name:KLAUSCHIE, LINDA K
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:KLAUSCHIE
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 1:3901 GEORGIA ST NE
Mailing Address - Street 2:SUITE A-4
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1359
Mailing Address - Country:US
Mailing Address - Phone:505-453-7307
Mailing Address - Fax:505-293-0617
Practice Address - Street 1:3901 GEORGIA ST NE
Practice Address - Street 2:SUITE A-4
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-1359
Practice Address - Country:US
Practice Address - Phone:505-453-7307
Practice Address - Fax:505-293-0617
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0121671101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health