Provider Demographics
NPI:1578530432
Name:PAQUETTE, LINDA LOUISE (MS, LISAC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:LOUISE
Last Name:PAQUETTE
Suffix:
Gender:F
Credentials:MS, LISAC
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 1811
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86405-1811
Mailing Address - Country:US
Mailing Address - Phone:928-846-7184
Mailing Address - Fax:
Practice Address - Street 1:1948 MESQUITE AVE
Practice Address - Street 2:103
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5777
Practice Address - Country:US
Practice Address - Phone:928-846-7184
Practice Address - Fax:928-854-6277
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC1380101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor