Provider Demographics
NPI:1205226529
Name:LINDSAY, DARYL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8616
Mailing Address - Country:US
Mailing Address - Phone:706-512-0579
Mailing Address - Fax:
Practice Address - Street 1:7119 LANGLEY ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-6105
Practice Address - Country:US
Practice Address - Phone:850-623-7551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10024103TC0700X
MO2007011145103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical