Provider Demographics
NPI:1326571134
Name:NISBETT, LYDIA
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:NISBETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 SEMORAN NORTH CIR
Mailing Address - Street 2:103
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1443
Mailing Address - Country:US
Mailing Address - Phone:863-529-5134
Mailing Address - Fax:
Practice Address - Street 1:1779 SEMORAN NORTH CIR
Practice Address - Street 2:103
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1443
Practice Address - Country:US
Practice Address - Phone:863-529-5134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker