Basic Information
Provider Information
NPI: 1487803847
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUTTERFIELD
FirstName: JO-LINDA
MiddleName: WESTON
NamePrefix:  
NameSuffix:  
Credential: PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1407 YORK RD
Address2: SUITE 309
City: LUTHERVILLE
State: MD
PostalCode: 210936097
CountryCode: US
TelephoneNumber: 4108252281
FaxNumber: 4108250757
Practice Location
Address1: 1407 YORK RD
Address2: SUITE 309
City: LUTHERVILLE
State: MD
PostalCode: 210936097
CountryCode: US
TelephoneNumber: 4108252281
FaxNumber: 4108250757
Other Information
ProviderEnumerationDate: 09/10/2008
LastUpdateDate: 09/16/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X02803MDY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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