Provider Demographics
NPI:1154010791
Name:AMILIAN, LINDSAY (BCHHP)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:AMILIAN
Suffix:
Gender:F
Credentials:BCHHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 TACOMA BRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-0868
Mailing Address - Country:US
Mailing Address - Phone:405-696-6005
Mailing Address - Fax:
Practice Address - Street 1:701 TACOMA BRIDGE CT
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-0868
Practice Address - Country:US
Practice Address - Phone:405-696-6005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK226263910171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach