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NPI Code Detail

MEDICARE: LINDSAY HAMILTON BROCHHAGEN LP

MEDICARE:   LINDSAY HAMILTON BROCHHAGEN  LP
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
1103TC0700XClinical Psychologist6301019452MI

General Provider Information

NPI Number : 1679060982
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY HAMILTON BROCHHAGEN LP
Provider Business Mailing Address
First Line : 615 KINGSBURY ST
Second Line :
City : MAUMEE
State : OH
Zip : 43537-1865
Country : US
Telephone Number : 567-218-0185
Fax Number : 419-930-6721
Provider Business Practice Location Address
First Line : 3140 DUSTIN RD STE 1
Second Line :
City : OREGON
State : OH
Zip : 43616-4341
Country : US
Telephone Number : 567-218-0185
Fax Number : 419-930-6721
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2018
Last Update Date : 03/24/2026

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Directions to “ LINDSAY HAMILTON BROCHHAGEN LP” Practice Location

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