Provider Demographics
NPI:1174744502
Name:MYERS, LINDA JAMES (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:JAMES
Last Name:MYERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 SUNBURY RD
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-1152
Mailing Address - Country:US
Mailing Address - Phone:614-218-1186
Mailing Address - Fax:510-601-1789
Practice Address - Street 1:2 ADMIRAL DR # B386
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1550
Practice Address - Country:US
Practice Address - Phone:510-601-1789
Practice Address - Fax:415-865-2636
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2035103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical