Provider Demographics
NPI:1568636892
Name:POTTINGER, LINDY SYLVAN (PHD)
Entity Type:Individual
Prefix:MS
First Name:LINDY
Middle Name:SYLVAN
Last Name:POTTINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:EVA
Other - Middle Name:SYLVAN
Other - Last Name:POTTINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:5232 VILLAGE CREEK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4437
Mailing Address - Country:US
Mailing Address - Phone:972-490-5757
Mailing Address - Fax:972-250-3364
Practice Address - Street 1:5232 VILLAGE CREEK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4437
Practice Address - Country:US
Practice Address - Phone:972-490-5757
Practice Address - Fax:972-250-3644
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31374103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist