Individual
DR. LINDA MONROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2410 GRAPE RD STE 1, MISHAWAKA, IN 46545-3015
(574) 243-9370
(574) 243-9375
Mailing address
2410 GRAPE RD STE 1, MISHAWAKA, IN 46545-3015
(574) 243-9370
(574) 243-9375
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040361A
IN
103TC0700X
Clinical Psychologist
6301011586
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100091350C
—
IN
01
—
351877953
TRICARE PROVIDER NUMBER
IN
Enumeration date
11/30/2006
Last updated
12/13/2019
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