Provider Demographics
NPI:1376220194
Name:HUMPHRIES, LINDSAY ROBIN
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ROBIN
Last Name:HUMPHRIES
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:PO BOX 2504
Mailing Address - Street 2:
Mailing Address - City:COLORADO CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86021-2504
Mailing Address - Country:US
Mailing Address - Phone:435-272-6500
Mailing Address - Fax:
Practice Address - Street 1:321 N MALL DR STE E102
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7305
Practice Address - Country:US
Practice Address - Phone:435-932-3672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker