Provider Demographics
NPI:1316787989
Name:LORO, LINDA EMMANUEL
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:EMMANUEL
Last Name:LORO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LINDA
Other - Middle Name:EMMANUEL
Other - Last Name:LORO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:8300 JEFFERSON NE SUITE B ALBUQUERQUE, NEW MEXICO 87113
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:87113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 FORT CROOK RD N STE 204
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-4226
Practice Address - Country:US
Practice Address - Phone:505-447-3825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician