Provider Demographics
NPI:1558515437
Name:MANNING, LINDA GAYLE (PHD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:GAYLE
Last Name:MANNING
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 1:3401 W END AVE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1042
Mailing Address - Country:US
Mailing Address - Phone:615-343-1554
Mailing Address - Fax:615-936-6144
Practice Address - Street 1:3401 W END AVE
Practice Address - Street 2:SUITE 380
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1042
Practice Address - Country:US
Practice Address - Phone:615-343-1554
Practice Address - Fax:615-936-6144
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2778103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist