Provider Demographics
NPI:1992361216
Name:TRUMP, LINDSEY ESTHER
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ESTHER
Last Name:TRUMP
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 1:152 ELM ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-3018
Mailing Address - Country:US
Mailing Address - Phone:330-388-7550
Mailing Address - Fax:
Practice Address - Street 1:899 FROST RD
Practice Address - Street 2:
Practice Address - City:STREETSBORO
Practice Address - State:OH
Practice Address - Zip Code:44241-4355
Practice Address - Country:US
Practice Address - Phone:330-963-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-15-19190103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty