Provider Demographics
NPI:1528279130
Name:LINZ, ROSINA (PHD)
Entity type:Individual
Prefix:DR
First Name:ROSINA
Middle Name:
Last Name:LINZ
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 1:3385 DEXTER CT STE 104
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3471
Mailing Address - Country:US
Mailing Address - Phone:563-459-6505
Mailing Address - Fax:563-459-6505
Practice Address - Street 1:3400 DEXTER CT STE 101
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3462
Practice Address - Country:US
Practice Address - Phone:563-459-6505
Practice Address - Fax:563-459-6505
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001049103T00000X
CAPSY14590103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist