Provider Demographics
NPI:1073701199
Name:BLASS, LINDSAY WALKER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:WALKER
Last Name:BLASS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 BELLE VIEW BLVD
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22307-6727
Mailing Address - Country:US
Mailing Address - Phone:703-596-5570
Mailing Address - Fax:
Practice Address - Street 1:1707 BELLE VIEW BLVD
Practice Address - Street 2:SUITE C-1
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-6727
Practice Address - Country:US
Practice Address - Phone:703-596-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist