| Doctor Name: | LINDA STORM |
| NPI Number: | 1174835995 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | P9104008 |
| Business Practice Address: | 408 South 7th Street Heber Springs, AR - 72543 |
| Business Phone Number: | 5013653022 |
| Business Fax Number: | 5013653086 |
| Mailing Address: | 408 Case St, HEBER SPRINGS |
| State: | AR |
| Postal Code: | 725432407 |
| Phone Number: | 5013628019 |
| Fax Number: | 5013653086 |
| NPI Enumeration Date: | 07/09/2010 |
| NPI Last Update Date: | 07/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | P9104008 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |