Provider Demographics
NPI:1619075702
Name:ESTES, LINDA SUE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:SUE
Last Name:ESTES
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 1:238 BROOKLEY AVE.
Mailing Address - Street 2:579 MDOS/SGOH
Mailing Address - City:BOLLING AFB
Mailing Address - State:DC
Mailing Address - Zip Code:20032
Mailing Address - Country:US
Mailing Address - Phone:202-767-0611
Mailing Address - Fax:202-767-2911
Practice Address - Street 1:238 BROOKLEY AVE.
Practice Address - Street 2:579 MDOS/SGOH
Practice Address - City:BOLLING AFB
Practice Address - State:DC
Practice Address - Zip Code:20032
Practice Address - Country:US
Practice Address - Phone:202-767-0611
Practice Address - Fax:202-767-2911
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3151103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical