Provider Demographics
NPI:1487851747
Name:NOLTE, LINDA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:J
Last Name:NOLTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 772162
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-2162
Mailing Address - Country:US
Mailing Address - Phone:970-879-3167
Mailing Address - Fax:970-879-3167
Practice Address - Street 1:351 8TH ST.
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487
Practice Address - Country:US
Practice Address - Phone:970-879-3167
Practice Address - Fax:970-879-3167
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPL 1237103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPL1237OtherPSYCHOLOGIST LICENSE NUMB
CO81636Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER