Provider Demographics
NPI:1508098211
Name:MEADE, LINDA LEE SUTTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LEE SUTTON
Last Name:MEADE
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 1:1016 W COLUMBIA ST
Mailing Address - Street 2:SEX OFFENDER REHABILITATION AND TREATMENT SERVICES
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-2902
Mailing Address - Country:US
Mailing Address - Phone:573-218-6019
Mailing Address - Fax:
Practice Address - Street 1:1016 W COLUMBIA ST
Practice Address - Street 2:SEX OFFENDER REHABILITATION AND TREATMENT SERVICES
Practice Address - City:FARMINGTON
Practice Address - State:MO
Practice Address - Zip Code:63640-2902
Practice Address - Country:US
Practice Address - Phone:573-218-6019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002030483103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist