Provider Demographics
NPI:1447767462
Name:MACDONALD, LINDSEY ROSE (BCBA)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ROSE
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 BAYOU RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32571-8647
Mailing Address - Country:US
Mailing Address - Phone:573-660-0245
Mailing Address - Fax:
Practice Address - Street 1:4891 GLOVER LN
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-4556
Practice Address - Country:US
Practice Address - Phone:850-471-8668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-29
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst