Provider Demographics
NPI:1497840128
Name:LAND, LINDA H (MSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:H
Last Name:LAND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 WINDHAM DR
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1835
Mailing Address - Country:US
Mailing Address - Phone:315-446-6570
Mailing Address - Fax:315-446-7270
Practice Address - Street 1:106 WINDHAM DR
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1835
Practice Address - Country:US
Practice Address - Phone:315-446-6570
Practice Address - Fax:315-446-7270
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR003676-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical