Provider Demographics
NPI:1730278979
Name:TUBER, LINDA (MSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:TUBER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 RIVERBEND RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301
Mailing Address - Country:US
Mailing Address - Phone:303-494-0358
Mailing Address - Fax:303-545-0076
Practice Address - Street 1:4860 RIVERBEND RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2614
Practice Address - Country:US
Practice Address - Phone:303-494-0358
Practice Address - Fax:303-545-0076
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9830191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical