Provider Demographics
NPI:1336966340
Name:SIGURDSON, LYDIA (PHD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:
Last Name:SIGURDSON
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 1:7165 CREEKBEND DR
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-9729
Mailing Address - Country:US
Mailing Address - Phone:716-696-2248
Mailing Address - Fax:
Practice Address - Street 1:6350 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5821
Practice Address - Country:US
Practice Address - Phone:716-783-3221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-21
Last Update Date:2024-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist