Provider Demographics
NPI:1932405578
Name:MOSBY, LINDA MARIE (MO)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARIE
Last Name:MOSBY
Suffix:
Gender:F
Credentials:MO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 REMARKABLE CT
Mailing Address - Street 2:
Mailing Address - City:GARNET VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19060-1113
Mailing Address - Country:US
Mailing Address - Phone:610-361-9005
Mailing Address - Fax:
Practice Address - Street 1:405 FOULK RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3809
Practice Address - Country:US
Practice Address - Phone:302-655-3953
Practice Address - Fax:302-655-1149
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-30
Last Update Date:2011-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional