Provider Demographics
NPI:1326165457
Name:HOUSTLE, LINDA BRUNSON (MAC, LAC, NCCAOM)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:BRUNSON
Last Name:HOUSTLE
Suffix:
Gender:F
Credentials:MAC, LAC, NCCAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WARREN RD
Mailing Address - Street 2:
Mailing Address - City:COCKEYSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21030-2404
Mailing Address - Country:US
Mailing Address - Phone:410-967-9808
Mailing Address - Fax:
Practice Address - Street 1:1107 KENILWORTH DR STE 210
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2136
Practice Address - Country:US
Practice Address - Phone:410-967-9808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01387171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist