Provider Demographics
NPI:1952448045
Name:PASQUA-BLAISSE, LINDA (MED)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:PASQUA-BLAISSE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1273 POTTERS LANE
Mailing Address - Street 2:
Mailing Address - City:KINTNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18930-9415
Mailing Address - Country:US
Mailing Address - Phone:610-346-7795
Mailing Address - Fax:
Practice Address - Street 1:245 W BROAD ST
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1242
Practice Address - Country:US
Practice Address - Phone:215-538-8575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005855L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling