Provider Demographics
NPI:1023616448
Name:JELINEK, LINDA JOAN
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:JOAN
Last Name:JELINEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 UNIVERSITY DR STE 115
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2391
Mailing Address - Country:US
Mailing Address - Phone:248-844-2647
Mailing Address - Fax:
Practice Address - Street 1:3250 UNIVERSITY DR STE 115
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2391
Practice Address - Country:US
Practice Address - Phone:248-844-2647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional