Provider Demographics
NPI:1659496560
Name:HEARN, LINDA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:M
Last Name:HEARN
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 1:880 N ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3276
Mailing Address - Country:US
Mailing Address - Phone:907-258-1937
Mailing Address - Fax:
Practice Address - Street 1:880 N ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3276
Practice Address - Country:US
Practice Address - Phone:907-258-1937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK398103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK92-0151400OtherTAX ID NUMBER