Provider Demographics
NPI:1821119330
Name:JOO, LINDA (MSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:JOO
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 1:121ST COMBAT SUPPORT HOSPITAL 611
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205
Mailing Address - Country:KR
Mailing Address - Phone:8227-918-4422
Mailing Address - Fax:7-918-4425
Practice Address - Street 1:121ST COMBAT SUPPORT HOSPITAL 611
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205
Practice Address - Country:KR
Practice Address - Phone:8227-918-4422
Practice Address - Fax:7-918-4425
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW013209L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist