Provider Demographics
NPI:1124435086
Name:MOUZON, LINDA E (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:E
Last Name:MOUZON
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 1:6945 SCARLET OAKS DR
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-6241
Mailing Address - Country:US
Mailing Address - Phone:410-796-5714
Mailing Address - Fax:
Practice Address - Street 1:6945 SCARLET OAKS DR
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6241
Practice Address - Country:US
Practice Address - Phone:410-796-5714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP4020101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional