MEDICARE: LISA LINDSAY

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
1	103TM1800X	Intellectual & Developmental Disabilities Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679177448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA LINDSAY

Provider Business Mailing Address
First Line	:	1303 PALMER STREET EXT
Second Line	:
City	:	MILTON
State	:	DE
Zip	:	19968-1045
Country	:	US
Telephone Number	:	302-573-1247
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 PALMER STREET EXT
Second Line	:
City	:	MILTON
State	:	DE
Zip	:	19968-1045
Country	:	US
Telephone Number	:	302-573-1247
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	11/23/2020

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Directions to “ LISA LINDSAY ” Practice Location

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