Provider Demographics
NPI:1497173736
Name:WILMSHURST, LINDA ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANNE
Last Name:WILMSHURST
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 1:2902 SW 4TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-4525
Mailing Address - Country:US
Mailing Address - Phone:336-417-1889
Mailing Address - Fax:
Practice Address - Street 1:12499 BRANTLEY COMMONS CT
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5676
Practice Address - Country:US
Practice Address - Phone:239-278-3443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-03
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9098103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist