Provider Demographics
NPI:1386756344
Name:LUDDEN, LINDA (EDD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:LUDDEN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 W RALPH HALL PKWY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-8701
Mailing Address - Country:US
Mailing Address - Phone:972-772-8484
Mailing Address - Fax:469-698-8569
Practice Address - Street 1:935 W RALPH HALL PKWY
Practice Address - Street 2:SUITE 105
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-8701
Practice Address - Country:US
Practice Address - Phone:972-772-8484
Practice Address - Fax:469-698-8569
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-2230103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033465801Medicaid
TX033465801Medicaid