Provider Demographics
NPI:1679865943
Name:WARE, LINDA COLL (OT, CHT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:COLL
Last Name:WARE
Suffix:
Gender:F
Credentials:OT, CHT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:JEAN
Other - Last Name:COLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT, CHT
Mailing Address - Street 1:6914 HOLABIRD AVENUE
Mailing Address - Street 2:
Mailing Address - City:DUNDLAK
Mailing Address - State:MD
Mailing Address - Zip Code:21222
Mailing Address - Country:US
Mailing Address - Phone:410-284-5441
Mailing Address - Fax:410-284-5442
Practice Address - Street 1:6914 HOLABIRD AVE
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-1747
Practice Address - Country:US
Practice Address - Phone:410-284-5441
Practice Address - Fax:410-284-5442
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02173225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist