Provider Demographics
NPI:1548373848
Name:STONE, LINDA MAZER (PSYD)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MAZER
Last Name:STONE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:A
Other - Last Name:MAZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1614 BEAUCHAMP ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-2404
Mailing Address - Country:US
Mailing Address - Phone:210-764-0252
Mailing Address - Fax:
Practice Address - Street 1:123 COMMERCE ST
Practice Address - Street 2:STE C
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4951
Practice Address - Country:US
Practice Address - Phone:830-792-4477
Practice Address - Fax:830-792-4546
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36132103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical