Provider Demographics
NPI:1538227814
Name:COHEN, LINDA DEBRA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:DEBRA
Last Name:COHEN
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 1:750 OCEAN ROYALE WAY
Mailing Address - Street 2:#1104
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-1325
Mailing Address - Country:US
Mailing Address - Phone:561-799-0395
Mailing Address - Fax:
Practice Address - Street 1:750 OCEAN ROYALE WAY
Practice Address - Street 2:#1104
Practice Address - City:JUNO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-1325
Practice Address - Country:US
Practice Address - Phone:561-799-0395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1571041C0700X
FL406106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist