Individual
MS. LINDA DEACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CS
Contact information
Practice address
11 REVERE ST APT 4, JAMAICA PLAIN, MA 02130-2880
(617) 524-4078
Mailing address
11 REVERE ST APT 4, JAMAICA PLAIN, MA 02130-2880
(617) 524-4078
Taxonomy
Speciality
Code
Description
License number
State
374K00000X
Religious Nonmedical Practitioner
Primary
—
—
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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