Provider Demographics
NPI:1821682246
Name:WALLINGFORD, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:WALLINGFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 TEAKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-8650
Mailing Address - Country:US
Mailing Address - Phone:513-410-2984
Mailing Address - Fax:
Practice Address - Street 1:830 TEAKWOOD CT
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-8650
Practice Address - Country:US
Practice Address - Phone:513-410-2984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care