Provider Demographics
NPI:1922151505
Name:TAKI, LINDA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:TAKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 OAKMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3714
Mailing Address - Country:US
Mailing Address - Phone:313-584-4120
Mailing Address - Fax:313-584-4135
Practice Address - Street 1:5141 OAKMAN BLVD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3714
Practice Address - Country:US
Practice Address - Phone:313-584-4120
Practice Address - Fax:313-584-4135
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical