Provider Demographics
NPI:1801326129
Name:MCABOY, LINDSAY DENISE (CTRS)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:DENISE
Last Name:MCABOY
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:MISS
Other - First Name:LINDSAY
Other - Middle Name:DENISE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CTRS
Mailing Address - Street 1:3075 ORCHARD VISTA DR SE
Mailing Address - Street 2:PO BOX 890
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-7069
Mailing Address - Country:US
Mailing Address - Phone:616-248-5100
Mailing Address - Fax:
Practice Address - Street 1:3075 ORCHARD VISTA DR SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7069
Practice Address - Country:US
Practice Address - Phone:616-248-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI59795225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist