Provider Demographics
NPI:1245510163
Name:ANDERSON, LINDSEY (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:WOOD RIVER JUNCTION
Mailing Address - State:RI
Mailing Address - Zip Code:02894-1126
Mailing Address - Country:US
Mailing Address - Phone:978-314-1345
Mailing Address - Fax:
Practice Address - Street 1:327 CHURCH ST
Practice Address - Street 2:
Practice Address - City:WOOD RIVER JUNCTION
Practice Address - State:RI
Practice Address - Zip Code:02894-1126
Practice Address - Country:US
Practice Address - Phone:978-314-1345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth