Provider Demographics
NPI:1053586495
Name:JEFFREY, LINDA RAE (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:RAE
Last Name:JEFFREY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 WEST AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08098-1124
Mailing Address - Country:US
Mailing Address - Phone:856-769-8808
Mailing Address - Fax:856-769-0960
Practice Address - Street 1:47 WEST AVE
Practice Address - Street 2:
Practice Address - City:WOODSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08098-1124
Practice Address - Country:US
Practice Address - Phone:856-769-8808
Practice Address - Fax:856-769-0960
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SL00348700103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist