Provider Demographics
NPI:1528539111
Name:EDWARDS, LINDSEY (LAC)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 JENNINGS RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2712
Mailing Address - Country:US
Mailing Address - Phone:301-602-0467
Mailing Address - Fax:
Practice Address - Street 1:8720 GEORGIA AVE STE 300
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3614
Practice Address - Country:US
Practice Address - Phone:301-565-4924
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-08
Last Update Date:2018-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02526171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist