Provider Demographics
NPI:1417467705
Name:GRAINGER, LINDSAY (BCBA)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:GRAINGER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 80 BOX 7
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96367-0001
Mailing Address - Country:US
Mailing Address - Phone:541-255-2561
Mailing Address - Fax:
Practice Address - Street 1:9815 ARNOLD TERRACE
Practice Address - Street 2:KADENA AIR BASE
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96367
Practice Address - Country:US
Practice Address - Phone:541-255-2561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst