Provider Demographics
NPI:1437594447
Name:PAUL, LINDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:PAUL-ELEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2626 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-7808
Mailing Address - Country:US
Mailing Address - Phone:727-258-7880
Mailing Address - Fax:
Practice Address - Street 1:8950 MARTIN LUTHER KING ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-3001
Practice Address - Country:US
Practice Address - Phone:727-576-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-05-2393103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst