Provider Demographics
NPI:1073922886
Name:LINDSEY, ANTONIO D
Entity Type:Individual
Prefix:
First Name:ANTONIO
Middle Name:D
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 PLEASANT HILL LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1779
Mailing Address - Country:US
Mailing Address - Phone:301-744-9211
Mailing Address - Fax:
Practice Address - Street 1:919 PLEASANT HILL LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1779
Practice Address - Country:US
Practice Address - Phone:301-744-9211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-06
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103TE1100X103TE1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports