Individual
LINDA WAKEFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
11370 N STATE ROAD 67, MOORESVILLE, IN 46158-6368
(317) 834-8187
(317) 834-8196
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 339-8109
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
19110111A
IN
Other
Enumeration date
02/24/2006
Last updated
05/04/2009
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