Provider Demographics
NPI:1356557953
Name:SMITH, LINDA MARIE (PHD, LMFT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 M D LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5349
Mailing Address - Country:US
Mailing Address - Phone:850-877-1746
Mailing Address - Fax:850-877-8215
Practice Address - Street 1:1407 M D LN
Practice Address - Street 2:SUITE A
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5349
Practice Address - Country:US
Practice Address - Phone:850-877-1746
Practice Address - Fax:850-877-8215
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0001488106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist