Doctor Name: | LINDA MIXON |
NPI Number: | 1013339001 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904008479 |
Business Practice Address: | 15941 Donald Curtis Dr Woodbridge, VA - 221914256 |
Business Phone Number: | 5408098970 |
Business Fax Number: | |
Mailing Address: | 30 Brown Cir, FREDERICKSBURG |
State: | VA |
Postal Code: | 224052806 |
Phone Number: | 5408098970 |
Fax Number: | |
NPI Enumeration Date: | 01/10/2014 |
NPI Last Update Date: | 01/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904008479 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |