Provider Demographics
NPI:1174540991
Name:PROTZMAN, LINDA S (MED CMHC, LPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:PROTZMAN
Suffix:
Gender:F
Credentials:MED CMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 S. WASHINGTON BLVD.
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-4900
Mailing Address - Country:US
Mailing Address - Phone:801-941-5783
Mailing Address - Fax:801-782-6616
Practice Address - Street 1:1065 S. WASHINGTON BLVD.
Practice Address - Street 2:SUITE # 4
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-4900
Practice Address - Country:US
Practice Address - Phone:801-941-5783
Practice Address - Fax:801-782-6616
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1352816004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional