Provider Demographics
NPI:1710089438
Name:COLLEVECCHIO, LINDA KNIGHTON (PHD)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:KNIGHTON
Last Name:COLLEVECCHIO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:LEE
Other - Last Name:COLLEVECCHIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3995 EAST MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402
Mailing Address - Country:US
Mailing Address - Phone:717-757-1227
Mailing Address - Fax:717-757-1353
Practice Address - Street 1:3995 EAST MARKET STREET
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-757-1227
Practice Address - Fax:717-757-1353
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006099L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist