Provider Demographics
NPI:1992029144
Name:YELLIN, LINDA ROCHELLE
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ROCHELLE
Last Name:YELLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29260 FRANKLIN RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1161
Mailing Address - Country:US
Mailing Address - Phone:248-363-8687
Mailing Address - Fax:
Practice Address - Street 1:29260 FRANKLIN RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1161
Practice Address - Country:US
Practice Address - Phone:248-363-8687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010201681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical