Provider Demographics
NPI:1952864290
Name:CLEPPER, LINDSAY BROOKE
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:BROOKE
Last Name:CLEPPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 BANTING DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-1460
Mailing Address - Country:US
Mailing Address - Phone:937-378-4811
Mailing Address - Fax:
Practice Address - Street 1:75 BANTING DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-1460
Practice Address - Country:US
Practice Address - Phone:937-378-4811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist