Provider Demographics
NPI:1275985624
Name:WILSON-BARLOW, LINDSAY D (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:D
Last Name:WILSON-BARLOW
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:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5171 S COTTONWOOD ST STE 810
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-5705
Practice Address - Country:US
Practice Address - Phone:801-507-9800
Practice Address - Fax:801-507-9801
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9606716-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical