Provider Demographics
NPI:1942075163
Name:GUEST, LINDA N (RBT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:N
Last Name:GUEST
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:GUEST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RBT
Mailing Address - Street 1:580 EMPIRE BLVD APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-3103
Mailing Address - Country:US
Mailing Address - Phone:929-370-2216
Mailing Address - Fax:
Practice Address - Street 1:999 CENTRAL AVE STE 303
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1205
Practice Address - Country:US
Practice Address - Phone:516-295-2019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23268750106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician