Provider Demographics
NPI:1578855441
Name:BRANCH, LINDSAY K (MS BCBA)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:K
Last Name:BRANCH
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 UNION FLATS BLVD
Mailing Address - Street 2:APT 3D
Mailing Address - City:WESTFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46074-7246
Mailing Address - Country:US
Mailing Address - Phone:810-357-4569
Mailing Address - Fax:
Practice Address - Street 1:12726 HAMILTON CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5422
Practice Address - Country:US
Practice Address - Phone:810-357-4569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2014-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-10-7670103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst