Provider Demographics
NPI:1164994778
Name:LINDEMAN, MERRIE FRANCES
Entity Type:Individual
Prefix:MRS
First Name:MERRIE
Middle Name:FRANCES
Last Name:LINDEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MERRIE
Other - Middle Name:FRANCES
Other - Last Name:HAMMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:415 MEDICAL DR STE D101
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8905
Mailing Address - Country:US
Mailing Address - Phone:801-683-1062
Mailing Address - Fax:801-295-5537
Practice Address - Street 1:327 W GORDON AVE STE 2
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-2381
Practice Address - Country:US
Practice Address - Phone:801-683-1062
Practice Address - Fax:801-295-5537
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician