Healthcare Provider Details

I. General information

NPI: 1861778177
Provider Name (Legal Business Name): LINDSAY OWINGS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2011
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N MAIN ST
CHATTAHOOCHEE FL
32324-1107
US

IV. Provider business mailing address

100 N MAIN ST
CHATTAHOOCHEE FL
32324-1107
US

V. Phone/Fax

Practice location:
  • Phone: 850-663-7891
  • Fax:
Mailing address:
  • Phone: 850-663-7891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY8378
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: