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NPI Code Detail

MEDICARE: LINDSAY C IBOS

MEDICARE: LINDSAY C IBOS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorC.2103680-TRNEOH

General Provider Information

NPI Number : 1366198848
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY C IBOS
Provider Business Mailing Address
First Line : 803 GRANT AVE
Second Line :
City : CUYAHOGA FALLS
State : OH
Zip : 44221-4607
Country : US
Telephone Number : 440-334-8457
Fax Number :
Provider Business Practice Location Address
First Line : 3757 FISHCREEK RD
Second Line :
City : STOW
State : OH
Zip : 44224-5404
Country : US
Telephone Number : 234-529-1994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2022
Last Update Date : 02/23/2022

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Directions to “ LINDSAY C IBOS ” Practice Location

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