Provider Demographics
NPI:1295342764
Name:QUALIA, LINDA R (PHD, LPC-SUPERVISOR)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:R
Last Name:QUALIA
Suffix:
Gender:F
Credentials:PHD, LPC-SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 FELICIA DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-3404
Mailing Address - Country:US
Mailing Address - Phone:214-929-0580
Mailing Address - Fax:
Practice Address - Street 1:2301 FELICIA DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-3404
Practice Address - Country:US
Practice Address - Phone:214-929-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1712101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional