Provider Demographics
NPI:1538393368
Name:SIOMPORAS, LINDA HALL (MED, LCPC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:HALL
Last Name:SIOMPORAS
Suffix:
Gender:F
Credentials:MED, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 RAWLINGS PL
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-2205
Mailing Address - Country:US
Mailing Address - Phone:410-562-0121
Mailing Address - Fax:
Practice Address - Street 1:1820 RAWLINGS PL
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2205
Practice Address - Country:US
Practice Address - Phone:410-562-0121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC2985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health