Provider Demographics
NPI:1508628934
Name:LINDSAY, LETICIA GUADALUPE (CSW)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:GUADALUPE
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-0325
Mailing Address - Country:US
Mailing Address - Phone:575-966-6131
Mailing Address - Fax:575-956-6947
Practice Address - Street 1:603 HADECO DR STE B
Practice Address - Street 2:
Practice Address - City:LORDSBURG
Practice Address - State:NM
Practice Address - Zip Code:88045-1813
Practice Address - Country:US
Practice Address - Phone:575-542-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker