Provider Demographics
NPI:1689431157
Name:PRICE, LINDA ROSE (MED, CAGS, LEP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ROSE
Last Name:PRICE
Suffix:
Gender:F
Credentials:MED, CAGS, LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NEW DRIFTWAY STE 302
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4546
Mailing Address - Country:US
Mailing Address - Phone:603-943-2124
Mailing Address - Fax:
Practice Address - Street 1:10 NEW DRIFTWAY STE 302
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4546
Practice Address - Country:US
Practice Address - Phone:603-943-2124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA880103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool