Provider Demographics
NPI:1386721306
Name:KNUST, LINDA C (PSYD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:C
Last Name:KNUST
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1838
Mailing Address - Country:US
Mailing Address - Phone:732-223-3540
Mailing Address - Fax:732-223-2731
Practice Address - Street 1:617 UNION AVE
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1838
Practice Address - Country:US
Practice Address - Phone:732-223-3540
Practice Address - Fax:732-223-2731
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100310800103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist