Provider Demographics
NPI:1720210271
Name:MARKWORTH, LINDSAY CHRISTINE (MMT, MT-BC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:CHRISTINE
Last Name:MARKWORTH
Suffix:
Gender:F
Credentials:MMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 38TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1722
Mailing Address - Country:US
Mailing Address - Phone:651-353-2903
Mailing Address - Fax:
Practice Address - Street 1:2800 38TH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1722
Practice Address - Country:US
Practice Address - Phone:651-353-2903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN08309225A00000X
MN225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist