Provider Demographics
NPI:1801994777
Name:ROESSLER, LINDA R (LMFT, RN,CS)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:R
Last Name:ROESSLER
Suffix:
Gender:F
Credentials:LMFT, RN,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:SUITE 214
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2901
Mailing Address - Country:US
Mailing Address - Phone:607-737-4040
Mailing Address - Fax:607-734-0774
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:SUITE 214
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2901
Practice Address - Country:US
Practice Address - Phone:607-737-4040
Practice Address - Fax:607-734-0774
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY000302-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist