Provider Demographics
NPI:1437303732
Name:KINZLER, LINDA GAIL (CRC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:GAIL
Last Name:KINZLER
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:GAIL
Other - Last Name:KINZLER NORHEIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRC
Mailing Address - Street 1:4100 W 3RD ST
Mailing Address - Street 2:VETERANS INDUSTRIES BLDG 410
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45428-9000
Mailing Address - Country:US
Mailing Address - Phone:937-268-6511
Mailing Address - Fax:937-262-5940
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:VETERANS INDUSTRIES BLDG 410
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-9000
Practice Address - Country:US
Practice Address - Phone:937-268-6511
Practice Address - Fax:937-262-5940
Is Sole Proprietor?:No
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
95778101YM0800X, 101YP2500X, 171M00000X
0095778103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No171M00000XOther Service ProvidersCase Manager/Care Coordinator